摘要
目的探讨高分辨率核磁共振(HR-MRI)在椎-基底动脉夹层动脉瘤(VBDA)诊疗中的作用。方法回顾性分析首都医科大学宣武医院2016年1月至12月收治的使用3.0 T HR-MRI检查时间飞跃法血管成像等序列,并经DSA确诊的VBDA患者62例,根据病史将其分为无症状组18例和症状组44例,分析其临床特点、影像学特点及与预后的关系。结果 HR-MRI显示,双腔征/内膜瓣在无症状组和症状组中分别占27.8%(5例)和54.5%(24例),壁间血肿在两组中分别占22.2%(4例)和43.2%(19例),瘤壁强化在两组分别占33.3%(6例)和77.3%(34例),以上特征两组比较差异均有统计学意义(均P<0.05)。症状组中18.2%(8例)的患者出现复发,明显高于无症状组的5.6%(1例),两组差异有统计学意义(P<0.05)。结论 HR-MRI能够较好显示VBDA的病变特点。症状性VBDA中瘤壁强化和复发比例均较高,提示HR-MRI可在一定程度上评估瘤壁的稳定性并判断预后。
Objective To investigate the roles of high-resolution magnetic resonance imaging （HR-MRI） in the diagnosis and treatment of vertebrobasilar dissecting aneurysms （VBDA）.Methods From January 2016 to December 2016,62 patients with VBDA admitted to Xuanwu Hospital,Capital Medical University using 3.0 T HR-MRI （3D-TOF-MRA,3D-T1WI,and 3D-T1WI＋C sequence） and diagnosed by DSA were analyzed retrospectively.They were divided into either an asymptomatic group （n=18） or a symptomatic group （n=44） according to their medical histories.Their clinical features,imaging features,and the relationship with prognosis were analyzed.Results HR-MRI revealed that the double lumen sign/intimal flap accounted for 27.8% （n=5） and 54.5% （n=24） respectively in the asymptomatic group and symptomatic group.The intramural hematoma accounted for 22.2% （n=4） and 43.2% （n=19） respectively in both groups.The enhancement of aneurysmal wall accounted for 33.3% （n=6） and 77.3% （n=34） in the asymptomatic group and symptomatic group.There were significant differences in the above features between the two groups （all P〈0.05）.In the symptomatic group,18.2% （n=8） of patients had aneurysm recurrence,which was significantly higher than the asymptomatic group （5.6%,n=1）.The difference between the two groups was statistically significant （P〈0.05）.Conclusions HR-MRI can better reveal the lesion characteristics of VBDA.The rates of aneurysmal wall enhancement and recurrence in symptomatic VBDAs are higher,which indicates that HR-MRI can assess the stability of the aneurysmal wall and identify the prognosis to a certain extent.
出处
《中国脑血管病杂志》
CAS
CSCD
北大核心
2017年第7期340-344,共5页
Chinese Journal of Cerebrovascular Diseases
基金
北京脑脊髓血管病临床数据与样本资源库发展与应用研究(D131100005343017)
关键词
高分辨率核磁共振成像
椎-基底动脉夹层动脉瘤
瘤壁稳定性
复发
High-resolution magnetic resonance imaging
Vertebrobasilar dissecting aneurysm
Stability of aneurysmal wall
Recurrence
