Clinic and Policlinic of Nuclear Medicine, University Hospital Würzburg, Germany.
Department of Radiology, University Hospital Regensburg, Germany.
Rofo. 2021 Apr;193(4):446-458. doi: 10.1055/a-1253-8422. Epub 2020 Oct 1.
To assess morphological and hemodynamic characteristics of peripheral vascular malformations on 3 T magnetic resonance imaging (MRI) including qualitative comparison of two fat-saturated sequences: short tau inversion recovery (STIR) and three-dimensional high-resolution volume interpolated gradient recalled echo (GRE).
During 9 months, 100 patients with suspected or known vascular malformations were prospectively assessed on a 3 T scanner using T2-weighted STIR and turbo spin echo (TSE), T1-weighted TSE, time-resolved contrast-enhanced magnetic resonance angiography (MRA) with interleaved stochastic trajectories (TWIST) and T1-weighted volume interpolated breath-hold examination (VIBE) after contrast enhancement. The analysis included signal behavior and morphologic and hemodynamic characteristics. Additionally, the image quality of the fat-saturated sequences was evaluated by 2 radiologists.
86 patients (14 dropouts; 57 female, 29 male; mean age 26.8 years, age range 1-56) were analyzed. 22 had high-flow and 64 low-flow malformations, including 14 with a lymphatic component. In 21 of 22 patients with high-flow malformations, typical characteristics (flow voids, hyperdynamic arteriovenous fistula, dilated main/feeder-arteries and draining veins) were documented. Patients with low-flow malformations had phleboliths in 35 cases, fluid-fluid levels in 47 and dilated draining veins in 23. Lymphatic malformations showed peripheral contrast enhancement of cyst walls in the volume interpolated GRE. The comparison of fat-saturated sequences showed significantly better results of the volume interpolated GRE in all categories except the presence of artifacts which were significantly reduced in the STIR (p < 0.05).
3 T MRI with MRA provides detailed morphological and hemodynamic information of different types of peripheral vascular malformations. Contrast-enhanced high-resolution volume interpolated GRE proved superior to STIR in differentiating morphologic features and to be diagnostic in the differentiation of lymphatic parts and joint involvement.
· 3 T MRI with MRA offers detailed information about vascular malformations.. · Fat-saturated MRI provides especially information about morphological characteristics, extent and tissue involvement.. · Volume interpolated GRE proved superior in almost all categories compared to STIR.. · Volume interpolated GRE showed more artifacts.. · Volume interpolated GRE additionally allows differentiation of lymphatic parts and evaluation of joint involvement..
· Höhn F, Hammer S, Fellner C et al. 3T MRI of Peripheral Vascular Malformations: Characteristics and Comparison of Two Fat-Saturated sequences: Short Tau Inversion Recovery Versus Three-Dimensional High-Resolution Volume Interpolated Gradient Recalled Echo. Fortschr Röntgenstr 2021; 193: 446 - 458.
在 3T 磁共振成像（MRI）上评估外周血管畸形的形态和血流动力学特征，包括两种饱和脂肪序列的定性比较：短回波时间反转恢复（STIR）和三维高分辨率容积内插梯度回波（GRE）。
在 9 个月的时间里，100 名疑似或已知血管畸形的患者在 3T 扫描仪上进行前瞻性评估，使用 T2 加权 STIR 和涡轮自旋回波（TSE）、T1 加权 TSE、时间分辨对比增强磁共振血管造影（MRA）与交错随机轨迹（TWIST）和 T1 加权容积内插屏气检查（VIBE）进行对比增强后。分析包括信号行为、形态和血流动力学特征。此外，由 2 名放射科医生评估饱和脂肪序列的图像质量。
分析了 86 名患者（14 名脱落；57 名女性，29 名男性；平均年龄 26.8 岁，年龄范围 1-56 岁）。22 例为高流量畸形，64 例为低流量畸形，其中 14 例伴有淋巴成分。在 22 例高流量畸形患者中，21 例记录到典型特征（血流空化、高动力动静脉瘘、主/供血动脉和引流静脉扩张）。低流量畸形患者中有 35 例存在静脉石，47 例存在液-液水平，23 例存在扩张的引流静脉。淋巴管畸形在容积内插 GRE 中显示囊壁的外周对比增强。饱和脂肪序列的比较显示，除了伪影明显减少（p<0.05）外，容积内插 GRE 在所有类别中的结果明显优于 STIR。
3T MRI 联合 MRA 可提供不同类型外周血管畸形的详细形态和血流动力学信息。增强后高分辨率容积内插 GRE 有助于区分形态特征，对鉴别淋巴管部分和关节受累具有诊断价值。
· 3T MRI 联合 MRA 可提供有关血管畸形的详细信息。
· 饱和脂肪 MRI 特别提供有关形态特征、范围和组织受累的信息。
· 与 STIR 相比，容积内插 GRE 在几乎所有类别中均显示出更高的优越性。
· 容积内插 GRE 显示更多伪影。
· 容积内插 GRE 还可以区分淋巴管部分并评估关节受累情况。
