Chooi Weng Kong, Woodhouse Neil, Coley Stuart C, Griffiths Paul D
Section of Academic Radiology, University of Sheffield, Royal Hallamshire Hospital, Sheffield, England.
AJNR Am J Neuroradiol. 2004 Aug;25(7):1251-5.
Pediatric head and neck lesions can be difficult to characterize on clinical grounds alone. We investigated the use of dynamic MR digital subtraction angiography as a noninvasive adjunct for the assessment of the vascularity of these abnormalities.
Twelve patients (age range, 2 days to 16 years) with known or suspected vascular abnormalities were studied. Routine MR imaging, time-of-flight MR angiography, and MR digital subtraction angiography were performed in all patients. The dynamic sequence was acquired in two planes at one frame per second by using a thick section (6-10 cm) selective radio-frequency spoiled fast gradient-echo sequence and an IV administered bolus of contrast material. The images were subtracted from a preliminary mask sequence and viewed as a video-inverted cine loop.
In all cases, MR digital subtraction angiography was successfully performed. The technique showed the following: 1) slow flow lesions (two choroidal angiomas, eyelid hemangioma, and scalp venous malformation); 2) high flow lesions that were not always suspected by clinical examination alone (parotid hemangioma, scalp, occipital, and eyelid arteriovenous malformations plus a palatal teratoma); 3) a hypovascular tumor for which a biopsy could be safely performed (Burkitt lymphoma); and 4) a hypervascular tumor of the palate (cystic teratoma).
Our early experience suggests that MR digital subtraction angiography can be reliably performed in children of all ages without complication. The technique provided a noninvasive assessment of the vascularity of each lesion that could not always have been predicted on the basis of clinical examination or routine MR imaging alone.
仅通过临床症状很难对儿童头颈部病变进行特征性诊断。我们研究了动态磁共振数字减影血管造影术作为一种非侵入性辅助手段，用于评估这些异常病变的血管情况。
对12例已知或疑似血管异常的患者（年龄范围为2天至16岁）进行研究。所有患者均接受常规磁共振成像、时间飞跃磁共振血管造影和磁共振数字减影血管造影检查。通过使用厚层（6 - 10厘米）选择性射频扰相快速梯度回波序列，并静脉注射造影剂团注，以每秒一帧的速度在两个平面采集动态序列图像。将这些图像与初步的蒙片序列相减，并以视频反转电影环的形式查看。
所有病例中，磁共振数字减影血管造影均成功完成。该技术显示出以下情况：1）血流缓慢的病变（两个脉络膜血管瘤、眼睑血管瘤和头皮静脉畸形）；2）仅通过临床检查并不总能怀疑到的高血流病变（腮腺血管瘤、头皮、枕部和眼睑动静脉畸形以及一个腭部畸胎瘤）；3）可以安全进行活检的低血运肿瘤（伯基特淋巴瘤）；4）腭部的高血运肿瘤（囊性畸胎瘤）。
我们的早期经验表明，磁共振数字减影血管造影术可在各年龄段儿童中可靠地进行，且无并发症。该技术提供了对每个病变血管情况的非侵入性评估，而这仅根据临床检查或常规磁共振成像并不总能预测出来。
