【摘要】 目的通过DSA手段确诊儿童外周静脉畸形,回顾性分析其MRI的表现特点,旨在提高术前MRI诊断静脉畸形的水平。方法采集我院2014年1月至2019年12月共98例静脉畸形患儿影像资料,均通过DSA手术确诊,回顾性分析其MRI的表现特征。结果 98例患儿共147处病变, DSA根据Puig分型其中Ⅰ型50处,Ⅱ型22处,Ⅲ型5处,Ⅳ型70处。MRI表现特征:T1WI信号表现多样,以等低信号为主;T₂WI呈高信号或等高混杂信号,部分可见"石榴籽"征,其为P uig分型中Ⅰ型和Ⅱ型特征性表现;病变长轴与肌束方向一致,多为Puig分型中Ⅲ型和Ⅳ型的表现;病变呈网状,为Puig分型中Ⅳ型的表现;盗病变边缘多发分叶;少数静脉畸形急性期伴出血,可伴有液液平面,不能据此排除静脉畸形。增强扫描多为不均匀强化,少部分明显强化,不强化者罕见。结论 DSA是诊断血管性病变的"金标准",可准确判断病变性质、形态、血供特点,同时还可进行硬化治疗。MRI诊断静脉畸形有其表现特征,可较为准确地判断静脉畸形的复杂病理成分,评价静脉畸形的大小、形态以及周围结构受累情况,从而指导临床制定治疗方案。更多还原

【Abstract】 Objective To retrospectively analysis MRI characteristics of peripheric venous malformations in children diagnosed by DSA, and improve preoperative diagnosis of venous malformation. Methods From January 2014 to December 2019, the imaging data of 98 patients with venous malformation were reviewed. All cases were diagnosed by angiography and interventional therapy. Their MRI characteristics were retrospectively analyzed. Results Ninety-eight children with 147 lesions were identified. All the lesions were evaluated by Puig classification, included 50 lesions of type Ⅰ, 22 lesions of type Ⅱ, 5 lesions of type Ⅲ and 70 lesions of type Ⅳ. On T₁WI, lesions had various features,most lesions showed iso-hypointensity signal. On T₂WI, most lesions demonstrated hyperintensity or iso-hyperintensity with hypointensity in between. Most lesions showed lobulated shape, some of them had pomegranate seed sign, which is the feature of type Ⅰ and Ⅱ in Puig classification. The long axis of the lesions of type Ⅲ and Ⅳ was aligned with the direction of the muscle bundle. Lesions of type Ⅳ showed reticular shape. Few of lesions had fluid-fluid levels when hemorrhage during acute phase,which cannot be excluded. On contrast enhanced images, heterogeneous and obvious enhancement are more common than those lack of enhancement. Conclusion DSA is the gold standard in diagnosing vascular disease. It can accurately evaluate the origin, shape and local circulation of the lesions as well as help interventional sclerotherapy. Venous malformation shows unique characteristic in MRI. MRI can reflect complex pathological feature and it is helpful in identifying size, shape of lesions and other involvement, and eventually provide information for treatment.更多还原