SWI在隐匿性局部微出血预示脑动静脉畸形破裂出血的危险性分析

摘要

Objective To explore the application value of Susceptibility Weighted Imaging (SWI) in the diagnosis of brain arteriovenous malformation (BAVM) with concealed regional micro hemorrhage and to predict factor risk of BAVM rupture hemorrhage.Methods This study retrospectively analyzed 24 cases of patients with BAVM that were confirmed by pathology after surgery. MRI and SWI scans were used to reconstruct the BAVM imaging with minimal intensity projection.Results 11 cases were diagnosed with old hemorrhage accompanied by concealed regional micro hemorrhage, and 15 cases had symptomatic intracranial hemorrhage, chi square test indicated that diagnostic accuracy was 73.3%. In the multivariable logic regression analysis model, old hemorrhage and concealed regional micro hemorrhage are closely related (OR=8.81, 95%CI: 0.75~102.92,P=0.083, <0.1); deep venous drainage and concealed regional micro hemorrhage of old hemorrhagic are closely related (OR=10.88, 95%CI: 0.86~136.96,P=0.065, <0.1).Conclusion Diagnosing concealed regional micro hemorrhage with SWI can evaluate risk of BAVM rupture.%目的：探讨磁敏感加权成像（Susceptibility Weighted Imaging，SWI）在诊断脑动静脉畸形（Brain Arteriovenous Malformation，BAVM）中隐匿性局部微出血的应用价值，来预示脑动静脉破裂出血的危险性及各因素的相关分析。方法回顾性分析经外院术后病理证实BAVM内微出血的患者24例，术前行MRI及SWI扫描，运用最小密度投影（Minimum Intensity Projection，MIP）重建来显示脑部动静脉畸形微出血情况。结果通过SWI诊断陈旧性出血伴隐匿性局部微出血11例，有临床破裂出血症状的患者15例，卡方检验诊断准确性为73.3%。在多变量logic回归分析模型中，陈旧性出血与隐匿性局部微出血密切相关（OR=8.81，95%CI：0.75～102.92，P=0.083，<0.1）；深静脉引流与陈旧性出血内隐匿性局部微出血关系较为密切（OR=10.88，95%CI：0.86～136.96，P=0.065，<0.1）。结论 SWI诊断隐匿性局部微出血可以用来评估脑动静脉畸形破裂出血的危险性。