3.0T 磁共振血管成像诊断颅内动脉成窗畸形的临床应用

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。

Fenestration of intracranial artery diagnosed with 3.0T magnetic resonance angiography

Objective To evaluate the application of 3.0T magnetic resonance angiography (MRA) in diagnosis of intracranial 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 retrospectively 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 multiple 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 lesions, 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 vascular 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.