本文選題：顱內(nèi)動(dòng)脈瘤 + 磁共振血管成像��； 參考：《中國(guó)人民解放軍醫(yī)學(xué)院》2015年碩士論文

【摘要】：研究背景：磁共振血管成像是顱內(nèi)未破裂動(dòng)脈瘤篩查的重要技術(shù)之一,它具有無(wú)創(chuàng)、無(wú)輻射、無(wú)需靜脈給藥等優(yōu)點(diǎn),受到臨床親睞。但既往磁共振場(chǎng)強(qiáng)較低,成像質(zhì)量不高,磁共振血管成像的敏感度無(wú)法和數(shù)字減影血管造影術(shù)及CT血管成像術(shù)相比。近年來(lái),3T磁共振的臨床應(yīng)用及新的血管成像技術(shù)的發(fā)展,使得磁共振在顱內(nèi)未破裂動(dòng)脈瘤的形態(tài)和破裂風(fēng)險(xiǎn)的評(píng)估中發(fā)揮越來(lái)越重要的作用。目的：1.以DSA成像作為參照,在3TMRA上測(cè)量動(dòng)脈瘤的瘤頸、瘤體橫徑及頂徑距這三個(gè)形態(tài)學(xué)指標(biāo),評(píng)估兩者之間的差異;2.在高分辨磁共振上判斷瘤壁的薄弱部位、瘤壁增強(qiáng)顯影情況、并探索磁共振影像與術(shù)中所見(jiàn)的相關(guān)性。方法：第一部分 16例顱內(nèi)未破裂動(dòng)脈瘤患者行DSA和MRA檢查,分別在DSA和MRA上測(cè)量瘤頸、瘤體橫徑及頂徑距這三個(gè)參數(shù)。將三個(gè)參數(shù)分別進(jìn)行統(tǒng)計(jì)分析,判斷兩種檢查是否存在統(tǒng)計(jì)學(xué)差異。第二部分 16例患者均行高分辨血管壁成像(MSDE序列)及增強(qiáng)(CE MSDE)掃描,在MSDE序列上根據(jù)瘤壁顯影情況分級(jí)：瘤壁顯影≥60%為Ⅰ級(jí)。30%-60%瘤壁顯影為Ⅱ級(jí),≤30%瘤壁顯影為Ⅲ級(jí)：對(duì)比MSDE和CE MSDE上瘤壁顯影情況分為“明顯強(qiáng)化”、“一般強(qiáng)化”和“無(wú)強(qiáng)化”三組：16例患者中有12例行開(kāi)顱手術(shù),根據(jù)術(shù)前磁共振上對(duì)瘤壁厚度判斷情況與術(shù)中所見(jiàn)對(duì)比,結(jié)果分為三類：與預(yù)期一致,與預(yù)期相符,與預(yù)期不同。結(jié)果：第一部分 瘤頸平均值：DSA為9.29±4.04mm, MRA為8.93±4.72mm,差異無(wú)統(tǒng)計(jì)學(xué)意義(Z=-1.19,P=0.2340.05,r=0.968)；瘤體橫徑平均值：DSA為12.65±6.86mm, MRA為12.91±6.83mm,兩者差異無(wú)統(tǒng)計(jì)學(xué)意義(Z=-0.88,P=0.3790.05,r=0.933);頂頸距平均值：DSA為14.23±0.95mm, MRA為13.86±0.96mm,兩者差異無(wú)統(tǒng)計(jì)學(xué)意義(Z=-1.48,P=0.140.05,r=0.499)。第二部分MSDE序列上2例瘤壁1級(jí)顯影,8例瘤壁2級(jí)顯影,6例瘤壁3級(jí)顯影；CE MSDE上瘤壁1級(jí)顯影12例,2級(jí)顯影3例,3級(jí)顯影1例;在CE MSDE序列上2例瘤壁明顯強(qiáng)化,11例一般強(qiáng)化,3例無(wú)強(qiáng)化;在12例開(kāi)顱手術(shù)病例中,7例術(shù)中所見(jiàn)與預(yù)期一致,3例與預(yù)期相符,2例與預(yù)期不符。結(jié)論：3T磁共振上MRA是評(píng)估動(dòng)脈瘤形態(tài)的有效檢查;動(dòng)脈瘤的高分辨MSDE和CE MSDE圖像能提供動(dòng)脈瘤壁的重要信息,有助于未破裂動(dòng)脈瘤的手術(shù)策略制定和動(dòng)脈瘤破裂風(fēng)險(xiǎn)的評(píng)估。
[Abstract]:Background: magnetic resonance angiography (MRA) is one of the important techniques for the screening of intracranial unruptured aneurysms. It has the advantages of non-invasive, non-radiation and no intravenous administration. However, the sensitivity of Mr angiography can not be compared with that of digital subtraction angiography and CT angiography. In recent years, the clinical application of 3T magnetic resonance imaging and the development of new angiography technology make MRI play an increasingly important role in the evaluation of the morphology and risk of rupture of intracranial unruptured aneurysms. Purpose 1. The aneurysm neck, transverse diameter and parietal diameter of the aneurysm were measured on 3T MRA with DSA imaging as the reference, and the difference between them was evaluated. The weak position of the tumor wall and the enhancement of the tumor wall were determined on high resolution MRI, and the correlation between MRI and intraoperative findings was explored. Methods: in the first part, DSA and MRA were performed in 16 patients with unruptured intracranial aneurysms. The tumor neck, transverse diameter and parietal diameter were measured on DSA and MRA respectively. The three parameters were statistically analyzed to determine whether there were statistical differences between the two tests. In the second part, all 16 patients underwent high-resolution angiography (MSDE) and enhanced angiography (CE MSDE). According to the development of the tumor wall on the MSDE sequence, the tumor wall development 鈮，

本文編號(hào)：2101202