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1、脑发育性静脉异常的CT、MRI诊断作者:马永华,许守利,孙建刚,刘华,张荣坤单位:山东省泗水县人民医院影像科【摘要】目的探讨脑发育性静脉异常的CT、MR1表现,提高影像学诊断水平。方法搜集经病理及DSA证实的DVA38例,7例手术病理证实,31例DSA证实,全部病例均行MRI平扫及增强扫描,8例行CT检查,冋顾性分析其CT、MRI表现。结果发生于幕下11例,幕上27例。8例行CT检查中,4例平扫未见明显异常密度灶,2例可见右侧小脑半球出血灶,1例右侧额叶见高低密度混杂病灶。1例增强扫描见右侧额叶条纹状异常增强血管影及粗大的引流血
2、管相连。MR扫描显示淸晰,TlWkT2WI表现为条状血管流空影32例,并发海绵状血管瘤5例,表现为不均匀短T1长T2异常混杂信号。增强扫描显示明显强化的髓静脉及引流静脉,呈典型“水母头”状。幕卜DVA引流静脉汇入脑表而静脉者4例,汇入第四脑室的室管膜下静脉7例,幕上DVA引流静脉经皮层静脉汇入脑衣血静脉窦者15例,汇入室管膜下静脉者12例,即汇入脑表面静脉乂汇入脑深静脉者1例。结论CT诊断对该病特异性较小,MRI增强扫描多方位观察,可清楚显示DVA的典型表现,MR检查可完全替代DSA成为DVA首选及确诊检
3、查手段。【关键词】脑;发育性静脉异常;体层摄影术;X线计算机;磁共振成像BraindevelopmentalvenousanomalyoftheCT,MRIdiagnosisMAYong-hua,XUShou-li,SUNJian-gang,etal.DepartmentofImaging,thePeoplefl]HospitalofSishui,Sishui,273200,China[Abstract]ObjectiveToexplorethebraindevelopmentalvenousanomalyoftheCT,MRI
4、performanceandimprovethelevelofimagingdiagnosis・MethodsDSAcollectedbypathologyandDVA38confirmedcases,sevencasesofsurgicallyandpathologicallyconfirmedDSAconfirmed31cases,allcasesunderwentplainandenhancedMRIscan,8ofroutineCTexamination,theirretrospectiveanalysisofCT,MR
5、Iperformance.ResultsOccurredin11casesofthenextscreen,27casesofsupratentorial.8casesCTexamination,fourcasesofabnormalCTdensityhadnoobviouslesions,2casesofhemorrhagecanbeseentherightcerebellarhemispherelesions,onecasesoftherightfrontallobelesions,seehigh-densitymixed.1
6、casesofCT-likestripesseetherightfrontallobeabnormalvascularshadowtoenhancedrainageandlargebloodvesselsconnected.MRscanrevealedaclear,T1WI,T2WIshowedvascularflowvoidfilmstrip32cases,complicatedbycavernoushemangiomaoffivecases,showedashortT1unevenmixinglengthabnormalT2
7、signal.SignificantlyenhancedCTshowsmedullaryveinsandthevenousdrainage,showingatypical“mcdusnhead”shape・DVAunderthescreenintothecerebralvenousdrainagefromthesurfaceoffourcasesofvein,intothefourthventriclesubependymalveinsin7cases,supratentorialDVAdrainingv
8、einsintothebrainbythecorticalveinfromthesurfaceof15casesofvenoussinus,intothesubependymalFrom12casesofvein,thatis,intothebrainsurfa