3D-T_(2)-TSE和CE-MRA对脊髓硬脊膜动静脉瘘的诊断价值  

Diagnostic value of 3D-T_(2)-TSE and CE-MRA examinations in dural arteriovenous fistula

作　　者：欧阳烽 吴钦[1] 袁小入 余念祖 金鹏卓 陈晔 尹明雪 曾献军[1] OUYANGFeng;WU Qin;YUAN Xiao-jin(Imaging Department of the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院医学影像科,江西南昌330006 [2]南昌大学第一附属医院神经外科,江西南昌330006

出　　处：《放射学实践》2023年第8期1001-1005,共5页Radiologic Practice

基　　金：江西省自然科学基金(20192ACBL20040);江西省教育厅一般项目(GJ7170080)。

摘　　要：目的:探讨可变翻转角三维T_(2)加权快速自旋回波(3D-T_(2)-TSE)序列和CE-MRA检查对脊髓硬脊膜动静脉瘘(SDAVF)的诊断价值。方法:回顾2018年5月-2022年10月在我院经手术和/或DSA确诊的18例SDAVF患者的临床及影像资料。所有患者行CE-MRA及3D-T_(2)-TSE序列MRI扫描,分析和比较两种检查方法及两者联合对SDAVF的定位诊断价值。结果:3D-T_(2)-TSE序列对髓周畸形血管征的检出率为100%(18/18),对瘘口的定位诊断符合率为77.8%(14/18),对供血动脉的检出率为55.6%(10/18),并可显示脊髓肿胀(17/18)及马尾区结构紊乱(15/18)等征像;CE-MRA对瘘口、供血动脉及髓周畸形血管的检出率均为83.3%(15/18)。结合CE-MRA与3D-T_(2)-TSE两种技术,对瘘口的定位符合率达87.5%。结论:在SDAVF的定位诊断中,CE-MRA与3D-T_(2)-TSE检查各具优势,对于后续DSA检查及外科手术均具有良好的参考价值;两种序列联合可提高诊断效能,获得不逊色于DSA的定位诊断符合率。Objective:To evaluate the diagnostic value of 3D-T_(2)-weighted-sampling perfection with application-optimized contrasts using different flip-angle evolutions(3D-T_(2)-TSE)sequence and contrast enhanced magnetic resonance angiography(CE-MRA)in spinal dural arteriovenous fistulae(SDAVF).Methods:The clinical and imaging data of 18 patients with SDAVF confirmed by surgery or digital subtraction angiography(DSA)in our hospital from May 2018 to October 2022 were reviewed.All patients underwent CE-MRA and 3D-T_(2)-TSE examinations.The localization value of the two methods in SDAVF was analyzed and compared.Results:Based on 3D-T_(2)-TSE sequence,the detection rates of perimedullary malformed vessel and feeding artery were 100%(18/18)and 55.6%(10/18)respectively,with a good fistula location accuracy of 77.8%(14/18);structural disorder of the cauda equina area sign was clearly shown in 15 cases(83.3%,15/18),and spinal cord swelling was found in 17 cases(94.4%,17/18).Based on CE-MRA examination,the detection rate for fistula,supplying artery,and perimedullary malformed vessels was equivalent,approximately 83.3%(15/18).When combining CE-MRA and 3D-T_(2)-TSE,the fistula location accuracy reached 87.5%.Conclusion:In the localization and diagnosis of SDAVF,CE-MRA and 3D-T_(2)-TSE sequences both have good performance,with good reference value for subsequent DSA examinations and surgical operations.When combining the two sequences,their advantages were complemented,with diagnostic performance comparable to DSA.

关 键 词：硬脊膜动静脉瘘 磁共振成像 数字减影血管造影 定位诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R744.1[医药卫生—诊断学]