CAJ | 학술논문

目的探索颅内发育性静脉异常(DVAs)并发海绵状血管畸形(CCM)的临床及影像学特点.方法对分别以癫痫、头昏、头晕发病的3例患者行头颅MRI磁敏感成像(MRI-SWI)或T2快速梯度回波(T2FFE)、钆喷酸葡胺增强、MRA及全脑血管造影检查.结果 MRI-SWI或T2FFE可见边缘低信号、中心为不同强度混杂信号的爆米花样或网格状的病灶,分布于额叶皮质及皮质下,提示CCM；在MRI增强及全脑血管造影中可见水母头样表现,提示有DVAs.在分析DVAs和CCM的关系中发现CCM病灶均发生在DVAs区域,可见引流静脉与CCM病灶呈成角弯曲.结论 DVAs可并发CCM,影像学可提供有特征性的改变,DVAs血管因素可能是CCM形成的原因之一.
목적 탐색로내발육성정맥이상(DVAs)병발해면상혈관기형(CCM)적림상급영상학특점.방법 대분별이전간、두혼、두훈발병적3례환자행두로MRI자민감성상(MRI-SWI)혹T2쾌속제도회파(T2FFE)、구분산포알증강、MRA급전뇌혈관조영검사.결과 MRI-SWI혹T2FFE가견변연저신호、중심위불동강도혼잡신호적폭미화양혹망격상적병조,분포우액협피질급피질하,제시CCM；재MRI증강급전뇌혈관조영중가견수모두양표현,제시유DVAs.재분석DVAs화CCM적관계중발현CCM병조균발생재DVAs구역,가견인류정맥여CCM병조정성각만곡.결론 DVAs가병발CCM,영상학가제공유특정성적개변,DVAs혈관인소가능시CCM형성적원인지일.
Objective To investigate the clinical,neuroradiologic characteristics and possible causes in 3 patients with combined developmental venous anomalies (DVAs) and cerebral cavernous malformations (CCM).Methods The clinical examination,magnetic resonance imaging (MRI) T1-weighted (T1 WI),T2-weighted (T2WI),susceptibility-weighted imaging (SWI) or T2 fast field echo (T2 FFE),contrast-enhanced MRI at 1.5 T field strength and digital substrate angiography were performed in 3 patients.Results Three patients presented with the seizure,vertigo,and dizziness respectively.MRI findings of reticulated “popcorn like” lesion with complete hemosiden rim showed typical sign of CCM.DSA,contrast-enhanced MRI and MRI-SWI revealed the caput medusae of the medullary veins and collected veins which was drained into subcortical and deep venous system,which indicated DVAs in 3 patients.The angulated medullary veins and collected veins in approaching distal zone of CCM were observed.Conclusion DVAs can be combined with CCM.The angulated medullary veins and collected veins combined with CCM in same territory reveals that the angioarchitectural factors is a key factor in pathogenesis of cavernous malformation.