首页|颅内海绵状血管瘤MRI-SWI T1WI T2FLAIR增强序列检查特征比较观察

颅内海绵状血管瘤MRI-SWI T1WI T2FLAIR增强序列检查特征比较观察

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目的:探讨磁共振敏感加权成像(MRI-SWI)、磁共振T1加权成像(T1WI)、T2加权成像(T2WI)、T2液体衰减反转恢复序列(T2FLAIR)在诊断颅内海绵状血管瘤中的应用价值。方法:选取延安大学附属医院2019年3月至2023年3月初步诊断怀疑为颅内海绵状血管瘤患者153例作为研究对象,所有患者均在手术前完成了 MRI检查,包括 MRI-SWI、T1WI、T2WI、T2FLAIR检查,以手术病理学检查结果作为金标准,计算各种MRI检查方式对于诊断颅内海绵状血管瘤的价值。结果:MRI-SWI正确诊断97例海绵状血管瘤患者,共计准确检出病灶数量177个,T1WI正确诊断72例海绵状血管瘤患者,共计准确检出病灶数量121个,T2WI正确诊断77例海绵状血管瘤患者,共计准确检出病灶数量132个,T2FLAIR正确诊断82例海绵状血管瘤患者,共计准确检出病灶数量143个,MRI-SWI对海绵状血管瘤病灶的检出率高于 T1WI、T2WI、T2FLAIR(x2=28。698、P<0。05,x2=22。299、P<0。05,x2=16。257、P<0。05);T2FLAIR 对海绵状血管瘤病灶的检出率高于 T1WI(x2=7。211、P<0。05);T1WI、T2WI 对海绵状血管瘤病灶的检出率差异无统计学意义(x2=1。676、P>0。05);T2FLAIR、T2WI对海绵状血管瘤病灶的检出率差异无统计学意义(x2=1。972、P>0。05);T1WI海绵状血管瘤病灶主要表现为混杂信号(43。80%)、其次为低信号(30。58%);T2WI海绵 状血管瘤病灶主要表现为混杂信号(49。24%),主要特征为病灶中央呈点状或网格状高信号,周围边缘低信号,称之为"铁环征",其次为低信号(35。61%);T2FLAIR海绵状血管瘤病灶主要表现为类圆形或者圆形的混杂信号(58。33%),病灶内部显示为爆米花或者网格状,其次为低信号(34。09%);MRI-SWI海绵状血管瘤病灶主要表现为低信号(95。48%),主要显示病灶的周围含铁血黄素区域及瘤体,病灶周边及内部显示片状或点状低信号;T1WI、T2WI、T2FLAIR、MRI-SWI鉴别诊断海绵状血管瘤患者的灵敏度分别为74。23%、79。38%、84。54%、100%,特异度分别为85。71%、83。93%、78。57%、94。64%。结论:颅内海绵状血管瘤患者在接受MRI检查的情况下,MRI-SWI序列 较T1WI、T2WI、T2FLAIR序列具有更高 的诊断价值。
Comparative Observation of MRI-SWI T1WI T2WI and T2FLAIR in Diagnosing Intracranial Cavernous Hemangiomas
Objective:To investigate the diagnostic value of magnetic resonance susceptibility-weighted imaging(MRI-SWI),T1-weighted imaging(T1WI),T2-weighted imaging(T2WI),and T2 fluid-attenua-ted inversion recovery(T2FLAIR)in intracranial cavernous hemangioma.Methods:From March 2019 to March 2023,153 patients suspected of intracranial cavernous hemangioma were selected.All patients under-went preoperative MRI examinations,including MRI-SWI,T1WI,T2WI,and T2FLAIR.Surgical pathology results were used as the gold standard.The diagnostic values of the different MRI sequences were calculated.Results:MRI-SWI correctly diagnosed 97 patients with a total of 177 lesions,whereas T1WI correctly diag-nosed 72 patients with 121 lesions,T2WI correctly diagnosed 77 patients with 132 lesions,and T2FLAIR cor-rectly diagnosed 82 patients with 143 lesions.The detection rate of MRI-SWI for cavernous hemangiomas was significantly higher than that of T1WI,T2WI,and T2FLAIR(x2=28.698,P<0.05;x2=22.299,P<0.05;x2=16.257,P<0.05).The detection rate of T2FLAIR was higher than that of T1WI(x2=7.211,P<0.05).There were no significant differences in detection rates between T1WI and T2WI or between T2FLAIR and T2WI(x2=1.676,P>0.05;x2=1.972,P>0.05).MRI signal characteristics of cavernous hemangio-mas varied among the sequences.T1WI mainly showed mixed signals(43.80%)and low signals(30.58%).T2WI mainly showed mixed signals(49.24%),characterized by central punctate or reticulated high signals with low-signal peripheral borders,known as the"iron ring sign,"followed by low signals(35.61%).T2FLAIR mainly showed round or oval mixed signals(58.33%)with an internal appearance resembling pop-corn or reticulation,followed by low signals(34.09%).MRI-SWI predominantly showed low signals(95.48%),highlighting iron deposition areas and tumor bodies with patchy or punctate low signals in and around the lesions.Sensitivity and specificity for diagnosing cavernous hemangiomas were as follows:T1WI had a sen-sitivity of 74.23%and specificity of 85.71%;T2WI had a sensitivity of 79.38%and specificity of 83.93%;T2FLAIR had a sensitivity of 84.54%and specificity of 78.57%;MRI-SWI had a sensitivity of 100%and specificity of 94.64%.Conclusion:MRI-SWI provides a higher diagnostic value for intracranial cavernous hemangiomas compared to T1WI,T2WI,and T2FLAIR sequences.

Intracranial cavernous hemangiomaMRI susceptibility-weighted imagingT1-weighted imagingT2-weighted imagingT2 fluid-attenuated inversion recovery

冯天保、许超、陈真

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延安大学附属医院心脑血管医院放射科,陕西 延安 716000

陕西省延安市人民医院放射科,陕西 延安 716000

颅内海绵状血管瘤 磁共振敏感加权成像 磁共振T1加权成像 T2加权成像 T2液体衰减反转恢复序列

陕西省教育厅一般专项科学研究计划项目

20JG040

2024

河北医学
河北省医学会

河北医学

CSTPCD
影响因子:1.915
ISSN:1006-6233
年,卷(期):2024.30(7)