胡建新,王丽宁,张旭妃,高洁,朱明旺.原发性中枢神经系统血管炎的MRI特征[J].中国医学影像技术,2019,35(2):191~194
原发性中枢神经系统血管炎的MRI特征
MRI features of primary angiitis of central nervous system
投稿时间:2018-07-11  修订日期:2018-10-29
DOI:10.13929/j.1003-3289.201807084
中文关键词:  血管炎,中枢神经系统  磁共振成像  血管造影术
英文关键词:vasculitis, central nervous system  magnetic resonance imaging  angiography
基金项目:
作者单位E-mail
胡建新 首都医科大学三博脑科医院影像科, 北京 100093  
王丽宁 首都医科大学三博脑科医院影像科, 北京 100093  
张旭妃 首都医科大学三博脑科医院影像科, 北京 100093  
高洁 首都医科大学三博脑科医院影像科, 北京 100093  
朱明旺 首都医科大学三博脑科医院影像科, 北京 100093 mwzhu@sina.com 
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中文摘要:
      目的 分析原发性中枢神经系统血管炎(PACNS)的MRI特征。方法 回顾性分析16例PACNS患者的临床和MRI资料,观察其影像学表现特征。结果 16例PACNS,9例单发,7例多发,MRI共检出45个病灶,其中位于幕上38个(38/45,84.44%),脑干4个(4/45,8.89%),脊髓2个(2/45,4.44%),小脑半球1个(1/45,2.22%)。14例MRI表现为大片或斑片状影,2例表现为多发或单发肿块。病灶MR平扫呈T1WI低信号,T2WI高信号,FLAIR序列高信号;6例病灶内可见出血。16例DWI均呈高信号,其中ADC图呈高信号13例,低信号3例。病灶周围可见不同程度脑水肿。增强扫描14例可见强化,2例无明显强化。1例MRA检查可见左侧大脑前动脉A4段局限性狭窄。结论 PACNS的MRI表现复杂多样,需对病变影像学特征进行综合分析;肿块样PACNS与脑肿瘤鉴别困难。
英文摘要:
      Objective To explore MRI features of primary angiitis of central nervous system (PACNS). Methods Clinical and imaging data of 16 patients with PACNS were retrospectively analyzed. MRI features of PACNS were observed. Results Among 16 patients with PACNS, 9 patients were found with single lesion and 7 with multiple lesions. A total of 45 lesions were detected with MRI in all 16 patients, including 38 lesions (38/45, 84.44%) on the supratentorial, 4 lesions (4/45, 8.89%) in the brainstem, 2 lesions (2/45, 4.44%) in the spinal cord and 1 lesion (1/45, 2.22%) in cerebellum. Lesions of 14 patients were demonstrated large or patchy shaped on MRI, while multiple masses or single mass like lesions were found in the other 2 patients. For MR plain scan, the lesions were mainly hypointense on T1WI, hyperintense on T2WI and FLAIR images. Hemorrhage lesions were found in 6 patients. For DWI, hyperintense lesions were found in all of 16 patients, including 13 with hyperintense and 3 with hypointense in ADC map. Various degrees of edema were shown around the lesions. For enhanced MRI, enhanced lesions were found in 14 patients, while lesions without obvious enhancement were found in the other 2 patients. Only 1 patient underwent MRA, with A4 segment of the left anterior cerebral artery stenosis. Conclusion MRI manifestations of PACNS are complex and diverse. Comprehensive analysis of MRI features is needed, but mass-like PACNS is still difficult to be distinguished from brain tumors.
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