颅内静脉窦病变3DPC与3DTRICKS的影像学对比研究

摘要

Objective The features of 3D Time Resolved Imaging of Contrast Kinetics (3D TRICKS) and 3D Phase contrast (3D PC) in cerebral venous sinus diseases are compared to provide the implication for clinical practices.Methods Fifty patients with cerebral venous sinus thrombosis (CVST) were enrolled into this study (19 males, 31 females;age ranged from 25 to 56 years).The patients all underwent MR scan with GE Signa HDxt 1.5T and Signa HDxt 3.0T MR scanner using 8 Channel head&neck coil.After the head and neck sagittal 3D PC scan, the 3D TRICKS was performed after 0~5 seconds of the administration, and the 25~30 ml contrast agent was bolused with the flow of 3 ml/s, and then acquired 15 phases images.The raw data was processed with functional tool of volume reconstruction and enlarge measurement on the GE ADW 4.4 Workstation.The displaying capabilities on intracranial venous and thrombus were compared between 3D PC and 3D TRICKS sequences.Results In 50 patients with cerebral venous diseases, both two methods revealed 57 lesions in cerebral venous sinuses.The affected sinus lumen exhibited as stenosis, interrupt, filling defect and branches tortuous expansion.In 3D PC images, the main part of cerebral venous sinus was showed clearly, while the vascular continuity was poor, especially in the region of confluens sinuum with lumen interruption.Compared to those in 3D PC images, cerebral veins in 3D TRICKS image were ill-defined border and had better continuities.Statistical data analysis was done with the statistical software SPSS 19.0,andP<0.05wasconsideredasstatisticallysignificant.Conclusion 3DPCand3DTRICKSbothareeffective sequences in diagnosis of CVST.The diagnostic accuracy is basically the same, but the image details are slightly different.%目的：通过三维相位对比（3D PC）与三维时间分辨对比剂动态显像（3D TRICKS）技术影像学特征对比研究，旨在掌握其各自特点，为临床正确应用提供参考。方法收集50例脑静脉窦疾病患者，男19例，女31例，年龄25～56岁，平均32．6岁。使用GE Signa HDxt 1．5T和Signa HDxt 3．0T磁共振机，线圈采用8通道头颈联合线圈（8 Channel head＆neck A），先行颅脑MRI平扫及行头颈部矢状面3D PC扫描，然后经肘静脉注射25～30 ml钆喷酸葡胺静脉注射液，流率为3 ml／s，延迟0～5 s启动3D TRICKS扫描，采集15个时相。图像后处理使用GE ADW4．4工作站行血管三维重组与数据分析，比较3D PC与3D TRICKS对颅内静脉病变显示能力，并用统计软件SPSS 19．0版行数据统计学分析，统计结果以P≤0．05为有统计学意义。结果50例脑静脉疾病患者中，3DPC与3D TRICKS显示病灶能力相同，均显示57个病灶。 P＞0．05无统计学意义。病变表现为受累静脉窦管腔狭窄、中断、充盈缺损及属支的迂曲扩张。两种检查技术从形态学上比较略有差异，3D PC图像清晰，血管分明可见，而血管连续性较差，特别在窦汇区常常出现静脉中断现象；3D TRICKS血管影像较模糊，血管边缘锐利度较差，但血管连续性较好。结论3DPC与3DTRICKS是诊断颅内静脉窦疾病的两种有效方法，诊断准确率相同，但在显示图像细节上各有其特点，并有互补性。