高分辨率血管壁成像在儿童中枢神经系统血管炎诊治中的应用  

The application of high resolution vascular wall imaging in the diagnosis and treatment of children's central nervous system vasculitis

作　　者：曹一民 张明峰[2] 张成烨 冯旭然 冯平勇[1] 周立霞[1] CAO Yimin;ZHANG Mingfeng;ZHANG Chengye;FENG Xuran;FENG Pingyong;ZHOU Lixia(Department of Medical Imaging,the Second Hospital of Hebei Medical University,Shijiazhuang 050051,China;Department of Rheumatology and Immunology,the Second Hospital of Hebei Medical Uhiversity,Shijiazhuang 050051,China;Chengde Medical University,Chengde,Hebei Province 067000,China)

机构地区：[1]河北医科大学第二医院医学影像科,河北石家庄050051 [2]河北医科大学第二医院风湿免疫科,河北石家庄050051 [3]承德医学院,河北承德067000

出　　处：《实用放射学杂志》2024年第9期1499-1502,共4页Journal of Practical Radiology

摘　　要：目的 探讨高分辨率血管壁成像(HRVWI)在儿童中枢神经系统血管炎(CNSV)诊断和治疗中的临床价值.方法 选取行HRVWI检查的儿童CNSV患者36例,回顾性分析HRVWI的影像学特征、累及血管的类型和狭窄程度,并与磁共振血管成像(MRA)比较.结合部分患者治疗后随访和影像学复查.结果 HRVWI显示36例儿童CNSV患者均存在脑动脉炎,受累的炎性血管表现为局部不同程度的管壁增厚伴强化,以均匀性增厚和向心性强化为主.中等强化型居多,且狭窄程度多为1级(21/36).根据受累的脑血管类型分为:大/中血管受累型26例、小血管受累型6例、混合型4例.与MRA比较,HRVWI诊断CNSV的敏感性更高(P<0.05).13例治疗后复查,HRVWI示脑血管炎缓解8例,进展5例,与临床症状和实验室指标的变化一致.结论 不同病因造成儿童CNSV的影像学特征各异,HRVWI对于儿童CNSV的诊断具有较高敏感性.HRVWI在儿童CNSV诊断和治疗中具有重要应用价值.Objective To investigate the clinical value of high resolution vascular wall imaging(HRVWI)in the diagnosis and treatment of central nervous system vasculitis(CNSV)in children.Methods A total of 36 children with CNSV underwent HRVWI examination were selected.The HRVWI imaging features,involved vessel types and stenosis degree were analyzed retrospectively and compared with magnetic resonance angiography(MRA).Combined with some patients' follow-up and reviewed imaging after treatment.Results HRVWI showed that all of the 36 children with CNSV had cerebral arteritis,and the affected inflammatory ves-sels showed varying degrees of focal arterial wall thickening and enhancement,mainly uniform thickening and centripetal enhance-ment of the affected arterial wall.Most were mid-enhanced,and the stenosis degree was mostly at level 1(21/36).According to the type of involvement cerebrovascular,there were 26 cases of large-medium vessel type,6 cases of small vessel type and 4 cases of mixed type.Compared with MRA,HRVWI had a higher sensitivity in diagnosing CNSV(P<0.05).13 cases were followed up after treat-ment,and HRVWI showed cerebral vasculitis relief in 8 cases and progression in 5 cases,consistent with changes in clinical symp-toms and laboratory indicators.Conclusion The imaging features of CNSV in children with different causes are different.HRVWI has a high sensitivity in the diagnosis of CNSV in children.HRVWI plays an important role in the diagnosis and treatment of CNSV in children.

关 键 词：中枢神经系统血管炎 高分辨率血管壁成像 磁共振成像 

分 类 号：R725.4[医药卫生—儿科] R445.2[医药卫生—临床医学]