SWI与SWIM对脑深静脉系统及外伤性脑静脉损伤的评价及应用

发布时间：2018-03-07 21:30

本文选题：磁共振成像　切入点：磁敏感加权成像　出处：《中南大学》2014年硕士论文　论文类型：学位论文

【摘要】：研究目的本研究通过3.OT磁共振磁敏感加权成像(susceptibility Weighted imaging, SWI)及SWIM(SWI Mapping)对颅内深静脉系统的显示能力评价,探讨其在创伤性颅脑静脉损伤中的应用价值。方法收集中南大学湘雅二医院2012-11～2014-01健康体检、自愿者和临床除外颅内静脉系统疾病行MRI检查者120例。男56例,女64例,年龄13～55岁,平均35.04岁。所有受检者经临床和常规MRI平扫除外颅内占位性病变、血管畸形和静脉窦血栓等相关疾病。由2名高年资影像科医师对深静脉系统的显示情况进行统计,分析。收集中南大学湘雅二医院2012-11～2013-12脑外伤患者60例。男37例,女23例,年龄13～72岁,平均39.05岁。所有受检者均分别在受伤后72H内及一月后行磁共振检查,分别命名为急性组1、复查组2,经临床和常规MRI平扫除外颅内占位性病变、血管畸形和静脉窦血栓及以前有过外伤史的患者。由2名高年资影像科医师判断出血灶,达成一致意见后对各序列显示的出血灶进行计数,对有疑问的出血灶不予进行统计。结合CT、SWI的phase图及SWIM连续层面排除小血管断面、脑内异物、空气和颅底伪影后,SWI phase图及SWIM图上的高信号为颅内出血灶。分别记录MRI常规序列及SWI、SWIM图上检测到的出血灶数目、分布特点、与损伤血管的对应关系,运用统计学分析软件SPSS13.0行统计分析,P0.05认为差异有统计学意义。结果本研究发现SWI及SWIM能够非常清晰的显示颅内深静脉的形态及解剖结构。对颅内一、二级深静脉的2分以上显示率为100%,三级深静脉2分以上显示率均在83.3%以上,其中,透明隔静脉及丘脑纹状体上静脉等三级深静脉的2分以上显示率均达100%。对急性组1的共60例样本统计分析,SWI及SWIM图像共检测出血灶数目为1105个,T1WI序列检查出血灶数目为741个,T2WI序列检测出血灶数目为772个,FLAIR序列检测出血灶数目为779个；SWI及SWIM图像较常规MR[序列能检测出更多的出血灶(P0.05),常规MRI序列T1WI、T2WI、FLAIR序列在显示出血灶数目能力上没有差别(P0.05)。对复查组2的60例样本统计分析,发现SWI及SWIM图像共检测出血灶数目为1001个,T1WI序列检查出血灶数目为636个,T2WI序列检测出血灶数目为652个,FLAIR序列检测出血灶数目为723个；SWI及SWIM图像较常规MRI序列能检测出更多的出血灶(P0.05),常规MRI序列T1WI、T2WI、FLAIR序列在显示出血灶数目能力上没有差别(P0.05)。对于急性组1患者,同时还发现对于急性组1,SWI及SWIM还发现57条大脑静脉血管有损伤征象,表现为血管增粗,边缘毛糙,信号明显不均匀等。SWI及SWIM所发现的1105个出血灶中,其中有277个出血灶可以找到其与损伤静脉血管的对应关系。结论磁共振SWI及SWIM对颅内深静脉系统具有良好的显示能力,能清晰显示颅内深静脉的数目、形态及解剖结构。对于创伤性颅脑损伤患者,SWI及SWIM图像可以显示脑静脉血管形态学的改变及损伤程度,能清晰显示颅内出血灶的大小,形态及数目,且较常规T1WI、T2WI、FLAIR序列发现更多的微小脑出血灶,并能判断出血灶与损伤静脉的对应关系,从而在对创伤性颅脑损伤病情的早期全面评估及判断预后中起到非常重要的作用。
[Abstract]:The purpose of this study is to evaluate the display ability of intracranial deep venous system by 3.OT magnetic susceptibility weighted imaging (susceptibility Weighted imaging) and SWIM (SWI Mapping), and to explore its application value in traumatic brain injury.
Methods collected in Xiangya No.2 Hospital of Central South University from 2012-11 to 2014-01 health examination, except 120 cases of intracranial venous system diseases underwent MRI examination. The clinical volunteers and 56 cases of male, female 64 cases, age 13~55 years, average 35.04 years old. All subjects by clinical and routine MRI plain sweep out intracranial lesions, vascular malformations and venous sinus thrombosis and other related diseases. By 2 senior radiologists on the deep venous system display statistics, analysis of Xiangya No.2 Hospital of Central South University from 2012-11 to 2013-12. In patients with traumatic brain injury in 60 cases. 37 cases were male, 23 were female, age 13~72 years, average 39.05 years old. All subjects were injured after 72H and January by MRI, named acute group 1, group 2 review, by clinical and routine MRI plain sweep out intracranial lesions, vascular malformations and venous sinus thrombosis and had a history of trauma patients by 2 high. Senior radiologists judged hemorrhage after the agreement was counted on each sequence showed hemorrhage, hemorrhage not to doubt the statistics. Combining with CT, phase map and SWIM SWI continuous level of small blood vessels in the brain to exclude section, foreign body, air and skull base artifact, high signal on phase map and SWI the SWIM diagram for intracranial hemorrhage were recorded. Conventional MRI sequences and SWI, SWIM detected hemorrhage number, distribution characteristics, and the relationship between vascular injury, using statistical analysis software SPSS13.0 for statistical analysis, P0.05 believes that the difference was statistically significant.
The results of this study showed that SWI and SWIM can and anatomical structure of intracranial deep venous morphology showed very clear. A two level of intracranial deep vein, 2 points above the display rate is 100%, three deep venous rate in more than 2 grade were above 83.3%, among them, the septum pellucidum vein and thalamostriate vein body three level deep vein showed 2 points above the rate of 100%. analysis on a total of 60 cases of acute sample statistics group 1, SWI and SWIM images were detected in 1105 foci of hemorrhage, hemorrhage T1WI sequence check number was 741, the T2WI sequence in the detection of hemorrhage quantity is 772, the FLAIR sequence to detect bleeding the number of foci is 779; SWI and SWIM images than conventional MR[sequences can detect more focal hemorrhage (P0.05), conventional MRI sequence T1WI, T2WI, FLAIR showed no difference in the sequence number on the ability of hemorrhage (P0.05). Analysis of the review group 60 cases 2 sample statistics, found that SWI and SWIM map A total number of 1001 detection of hemorrhage, hemorrhage T1WI sequence check number was 636, the T2WI sequence in the detection of hemorrhage quantity is 652, the FLAIR sequence in the detection of hemorrhage number was 723; SWI and SWIM images than conventional MRI sequences can detect more focal hemorrhage (P0.05), conventional MRI sequence T1WI. T2WI, FLAIR showed no difference in sequence number on the ability of hemorrhage (P0.05). The acute group of 1 patients, also found in the acute group 1, SWI and SWIM also found 57 cerebral venous vascular injury signs showed vascular thickening, rough edge, 1105 hemorrhage signal was uneven.SWI and SWIM found, of which 277 hemorrhage can be found in the corresponding relation with injury of vein.
Conclusion magnetic resonance SWI and SWIM have good display ability of intracranial deep venous system, can clearly display the number of intracranial deep venous, morphological and anatomical structure. For patients with traumatic brain injury, SWI and SWIM images can show the morphological changes of cerebral venous and damage, intracranial hemorrhage foci can clearly show the size, shape and the number, and compared with the conventional T1WI, T2WI, FLAIR sequence showed more small cerebral hemorrhage, and can judge the relationship between hemorrhage and injury of vein, so as to judge and play a very important role in the evaluation of prognosis in the early stage of the disease of traumatic brain injury.

【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2;R743

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