对比三维多回波T2血管成像与三维时间飞跃法MR血管成像诊断大脑半球梗死患者颅内大血管病变

摘要

目的 探讨三维多回波T2*血管成像(3D SWAN)诊断大脑半球梗死患者颅内大血管病变的价值.方法 对63例单侧脑梗死患者(起病时间为3 h～8天)行常规MR、DWI、3D SWAN及三维时间飞跃法MR血管成像(3D TOFMRA)检查,分析3D SWAN检测的颅内大动脉(包括大脑中动脉和颈内动脉颅内段)异常低信号,与3D TOF MRA显示的异常(中断、闭塞、狭窄)进行比较,判断两种方法对显示动脉异常的一致性,并计算Kappa值.结果 3D TOF MRA共显示28条大脑中动脉、9条颈内动脉中断、闭塞或狭窄,而3D SWAN则显示其中30条动脉出现异常低信号,3D SWAN与3D TOF MRA对显示大脑中动脉和颈内动脉颅内段的异常具有很好的一致性(Kappa值为0.867,P<0.05).结论 3D SWAN对诊断脑梗死患者大脑中动脉和颈内动脉颅内段异常有较高价值,分析3D SWAN动脉内异常低信号的特点有助于进一步判断3D TOF MRA显示的动脉中断、闭塞、狭窄的原因.%Objective To observe the value of three-dimensional T2* -weighted angiography (3D SWAN) in diagnosis of arterial stenosis or arterial obstruction in cerebral infarction.Methods Totally 63 patients with unilateral cerebral infarction were recruited and underwent conventional MR, three-dimensional time of flight angiography (3D TOF MRA), DWI and 3D SWAN within 3 h-8 d of symptom onset.The susceptibility hypointensity sign in middle cerebral arteries and internal carotid arteries on 3D SWAN was analyzed and was compared to the abnormalities of corresponding arteries of 3D TOF MRA including stenosis, occlusion and interruption, and the Kappa value was calculated.Results Twenty-eight middle cerebral arteries and 9 internal carotid arteries were demonstrated stenosis, occlusion or interruption on 3D TOF MRA.The susceptibility hypointensity sign was showed in 30 of corresponding arteries on 3D SWAN.There was consistency between susceptibility hypointensity in arteries on 3D SWAN and the stenosis, occlusion or interruption in corresponding arteries on 3D TOF MRA (Kappa value=0.867, P＜0.05).Conclusion It is valuable for diagnosing the abnormalities of middle cerebral arteries and internal carotid arteries with 3D SWAN.Investigating the characteristics of susceptibility hypointensity sign of 3D SWAN is helpful for showing the etiology of stenosis, occlusion or interruption of cerebral arteries on 3D TOF MRA.