高分辨率核磁共振在椎-基底动脉夹层动脉瘤诊治中的作用

发布时间：2018-10-09 11:32

【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P0.05)。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(P0.05)。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。
[Abstract]:Objective to investigate the role of high resolution magnetic resonance imaging (HR-MRI) in the diagnosis and treatment of vertebrobasilar dissecting aneurysm (VBDA). Methods from January to December 2016, 62 patients with VBDA diagnosed by DSA were analyzed retrospectively, who were treated in Xuanwu Hospital of Capital Medical University using 3.0T HR-MRI. According to the history, the patients were divided into asymptomatic group (n = 18) and symptomatic group (n = 44). Results HR-MRI showed that, Double lumen sign / intimal flap accounted for 27.8% (5 cases) and 54.5% (24 cases) in asymptomatic group and symptomatic group, 22.2% (4 cases) and 43.2% (19 cases) of interwall hematoma, 33.3% (6 cases) and 77.3% (34 cases) respectively. The difference was statistically significant (P0.05). In the symptom group, 18.2% (8 cases) showed recurrence, which was significantly higher than that in the asymptomatic group (5.6%), the difference between the two groups was statistically significant (P0.05). Conclusion HR-MRI can better display the pathological features of VBDA. The proportion of enhancement and recurrence of tumor wall in symptomatic VBDA is high, which suggests that HR-MRI can evaluate the stability of tumor wall and judge the prognosis to some extent.
【作者单位】：首都医科大学宣武医院神经外科;
【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)
【分类号】：R445.2;R743

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