海绵状血管畸形的动态特性：一项采用容积分析的前瞻性磁共振成像研究

Dynamic nature of cavernous malformations: a prospective magnetic resonance imaging study with volumetric analysis.

作者信息

Clatterbuck R E, Moriarity J L, Elmaci I, Lee R R, Breiter S N, Rigamonti D

机构信息

Department of Neurosurgery, The Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.

出版信息

J Neurosurg. 2000 Dec;93(6):981-6. doi: 10.3171/jns.2000.93.6.0981.

DOI:10.3171/jns.2000.93.6.0981

PMID:11117871

Abstract

OBJECT

Although cavernous malformations (CMs) are not detected in angiographic studies, they have a characteristic appearance on magnetic resonance (MR) images. A number of reports published in the last decade have focused on the behavior of these lesions within the clinical environment. However, little has been published about the evolution of CMs over time, as observed in imaging studies. To understand imaging-documented changes in CMs over time, we analyzed MR images of 114 cavernous malformations in 68 patients who were followed prospectively.

METHODS

For each CM the location, volume, and MR imaging signal characteristics were recorded. Volume data were available for 107 lesions from initial images. The mean volume of these 107 CMs was 2779 mm3. The lesions ranged in size from 0.5 to 46,533 mm3 (46.5 cm3). Volume data from a second set of images were available for 76 CMs (mean interval from first imaging session 26 months), and from a third set of images for 24 lesions (mean interval from second imaging session 18 months). Over the first follow-up interval, the mean volume change was -991 mm3 (a decrease of approximately 1 cm3) and over the second interval the mean volume change was -642 mm3. Although these mean volume changes appear modest, volume changes in single lesions during follow-up intervals were more dramatic, with decreases as large as 45,629 mm3 (45.6 cm3) and increases as large as 6,074 mm3 (6 cm3). Serial examinations of the MR imaging signal characteristics of these CMs demonstrate a trend for maturation of blood products from a subacute, to a mixed, and finally to a chronic appearance. Three lesions appeared de novo during the follow-up period.

CONCLUSIONS

On the basis of their analysis, the authors conclude that CMs exhibit a range of dynamic behaviors including enlargement, regression, and de novo formation, as well as progression through a series of characteristic MR imaging appearances.

摘要

目的

尽管海绵状血管畸形（CMs）在血管造影研究中未被检测到，但它们在磁共振（MR）图像上具有特征性表现。过去十年发表的一些报告聚焦于这些病变在临床环境中的行为。然而，关于CMs随时间的演变，在影像学研究中观察到的相关报道较少。为了解CMs随时间的影像学记录变化，我们分析了68例患者中114个海绵状血管畸形的MR图像，这些患者均接受了前瞻性随访。

方法

记录每个CM的位置、体积和MR成像信号特征。从初始图像中获取了107个病变的体积数据。这107个CMs的平均体积为2779立方毫米。病变大小范围为0.5至46533立方毫米（46.5立方厘米）。76个CMs有第二组图像的体积数据（距第一次成像的平均间隔时间为26个月），24个病变有第三组图像的体积数据（距第二次成像的平均间隔时间为18个月）。在第一个随访间隔期，平均体积变化为-991立方毫米（减少约1立方厘米），在第二个间隔期，平均体积变化为-642立方毫米。尽管这些平均体积变化似乎不大，但随访期间单个病变的体积变化更为显著，减少量高达45629立方毫米（45.6立方厘米），增加量高达6074立方毫米（6立方厘米）。对这些CMs的MR成像信号特征进行系列检查显示，血液产物有从亚急性到混合性，最终到慢性表现的成熟趋势。在随访期间有3个病变是新出现的。