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目的对比分析脑海绵状血管畸形(cerebral cavernous malformation,CCM)的CT、常规磁共振成像(cMRI)和磁敏感加权成像(SWI)的影像学特点,以提高对CCM的影像学表现的认识。资料与方法回顾性分析2008年6月至2010年7月间我院诊断为CCM的患者42例。采用Siemens Plus 4螺旋CT或Somatom Sensation 16 CT扫描仪和Siemens Trio Tim 3.0 T超导型磁共振系统进行扫描,分别从CCM的形态学表现、CCM出血表现和钙化表现对比分析其CT、cMRI和SWI的影像学表现特点。结果 42例脑CCM患者中,CT共发现病灶28个,表现为类圆形略高密度,发现钙化灶21个,出血灶10个;cMRI发现病灶45个,表现为“网格”状或“爆米花”样高低混杂信号,发现钙化灶8个,出血灶18个;SWI发现病灶106个,其中钙化灶45个,出血灶84个。此外SWI还能够显示CCM的另一病理生理特征:周围引流小静脉。结论 cMRI+SWI是诊断CCM的首选方法,能较好反映CCM的病理生理学特点,为临床诊断和治疗提供重要的影像学依据。
Objective To compare and analyze the imaging features of CT, conventional magnetic resonance imaging (cMRI) and magnetic resonance weighted imaging (SWI) of cerebral cavernous malformation (CCM) in order to improve the understanding of the imaging findings of CCM. Materials and Methods Retrospective analysis of 42 cases diagnosed as CCM in our hospital from June 2008 to July 2010. The CT, cMRI and SWI were analyzed by using the Siemens Plus 4 spiral CT or Somatom Sensation 16 CT scanner and the Siemens Trio Tim 3.0 T superconducting magnetic resonance system, respectively, from the morphological findings, CCM hemorrhage and calcifications of CCM Imaging features. Results Totally 28 lesions were found in 42 cases of brain CCM, showing a slightly higher density of similar round, found 21 calcification and 10 hemorrhagic lesions; cMRI found 45 lesions showed “grid” Or “popcorn” high and low mixed signals, found 8 calcification, hemorrhage 18; SWI found 106 lesions, including 45 calcification, bleeding 84. In addition SWI can show another pathophysiological feature of CCM: small venous drainage around. Conclusion cMRI + SWI is the first choice for the diagnosis of CCM. It can better reflect the pathophysiology of CCM and provide important imaging evidence for clinical diagnosis and treatment.