CAJ | 학술논문

目的：探讨3.0T磁共振血管成像（MRA）诊断颅内动脉成窗畸形（FIA）的临床应用价值，了解FIA的MRA表现、好发部位以及临床特征。方法回顾性分析2012年4月至2014年12月共78例FIA患者的血管畸形好发部位、类型及其合并其它颅内血管性病变的情况。78例患者均行MRA扫描，再将原始图像经AW4.5工作站采用最小密度投影（MIP）及三维容积重建（VR）两种方法进行血管重组，并对血管图像进行后处理。结果78例FIA患者中，单发61例，多发17例，共计95处。其中61例单发病例中位于基底动脉15例，位于前交通动脉区13例，位于大脑前动脉26例，位于大脑中动脉5例，位于大脑后动脉2例；17例多发病例中，位于基底动脉及左大脑前动脉6例，位于左椎动脉颅内段及左大脑前动脉7例，位于基底动脉及前交通动脉4例。78例患者中合并其它颅内血管性病变者占83.3%（65/78），双侧动脉对比一侧优势者36例，伴动静脉畸形（AVM）1例，永存三叉动脉3例，大脑前动脉A1段缺失16例，血管狭窄9例。结论3.0T MRA能清楚显示FIA的位置、形态及合并颅内其它血管病变的情况，是诊断FIA的首选、有效、无创的影像检查方法。
목적：탐토3.0T자공진혈관성상（MRA）진단로내동맥성창기형（FIA）적림상응용개치，료해FIA적MRA표현、호발부위이급림상특정。방법회고성분석2012년4월지2014년12월공78례FIA환자적혈관기형호발부위、류형급기합병기타로내혈관성병변적정황。78례환자균행MRA소묘，재장원시도상경AW4.5공작참채용최소밀도투영（MIP）급삼유용적중건（VR）량충방법진행혈관중조，병대혈관도상진행후처리。결과78례FIA환자중，단발61례，다발17례，공계95처。기중61례단발병례중위우기저동맥15례，위우전교통동맥구13례，위우대뇌전동맥26례，위우대뇌중동맥5례，위우대뇌후동맥2례；17례다발병례중，위우기저동맥급좌대뇌전동맥6례，위우좌추동맥로내단급좌대뇌전동맥7례，위우기저동맥급전교통동맥4례。78례환자중합병기타로내혈관성병변자점83.3%（65/78），쌍측동맥대비일측우세자36례，반동정맥기형（AVM）1례，영존삼차동맥3례，대뇌전동맥A1단결실16례，혈관협착9례。결론3.0T MRA능청초현시FIA적위치、형태급합병로내기타혈관병변적정황，시진단FIA적수선、유효、무창적영상검사방법。
Objective To evaluate the application of 3.0T magnetic resonance angiography (MRA) in diagnosis of in-tracranial artery fenestration deformity (FIA). Methods Seventy eight patients with FIA underwent MRA examination from April 2012 to December 2014. The imaging features, deformity sites and type, and other intracranial vascular lesions were retrospec-tively reviewed. The original vascular images were reconstructed and processed with AW4.5 workstation by minimum intensity projection(MIP) and volume rendering(VR) methods. Results Among 78 FIA patients, 61 cases had single lesions, 17 cases mul-tiple lesion with a total sites of 95. In 61 patients with single lesions, 15 were located in basilar artery, 13 in anterior communicating artery, 26 in anterior cerebral artery, 5 in middle cerebral artery and 2 in posterior cerebral artery. In 17 patients with multiple le-sions, 6 were located in basilar artery and left anterior cerebral artery, 7 in left vertebral artery intracranial segment and left anterior cerebral artery, 4 in basilar artery and anterior communicating artery. 65 out 78 cases (83.3%) were complicated with other vascu-lar lesions, with bilateral artery predominant in 36 cases, with arteriovenous malformation (AVM) in 1 case, trigeminal artery in 3 cases, A1 segment of anterior cerebral artery deletion in 16 cases and vascular stenosis in 9 cases. Conclusion 3.0T MRA as a non- invasive imaging method can effectively diagnose intracranial arteries fenestration and other intracranial vascular lesions.