Carriero A, Magarelli N, Samuele F, Palumbo L, Bocola V, Iezzi A
Istituto di Scienze Radiologiche e Formazione dell'Immagine, Università G. D'Annunzio, Chieti.
Radiol Med. 1994 Apr;87(4):441-6.
The authors report on a diagnostic pitfall which is often observed in magnetic resonance angiography (MRA) of intracranial vessels (time-of-flight 3D)--i.e., the absence of one of the two transverse sinuses. Fifty patients underwent MRA of the intracranial vessels with the TOF 3D (FISP) and the TOF 2D (FISP) techniques. Five patients were affected with sinus stenosis. MRA was performed with a 1.5-T superconductive magnet and a circular head coil. All patients underwent Magnetic Resonance Angiography with FISP 2D sequences (FA 40 degrees, TR 40 ms, TE 12 ms) acquired on coronal plane as well as FISP 3D (FA 15 degrees, TR 30 ms, TE 7 ms) acquired on axial plane. In the patients in whom FISP 2D sequences correctly demonstrated the whole confluence of sinuses, FISP 3D sequences always depicted the upper sagittal sinus, while the right transverse sinus was seen in 84.4% (38/45) of cases and the left transverse sinus in 24.2% (11/45) of cases. In the patients with a stenosis in the confluence of sinuses, FISP 3D sequences demonstrated two false-positive cases with respect to FISP 2D. The statistical analysis (McNemar test) of the results demonstrated the difference between 2D and 3D sequences in the detection of the two transverse sinuses to be statistically significant: p < 0.01 for the right transverse sinus and p < 0.001 for the left transverse sinus. In the study of the intracranial vessels (TOF 3D technique) the absence of one of the two transverse sinuses is suggestive of a diagnostic pitfall; the combination of 3D and 2D sequences answers this diagnostic question.
作者报告了一种在颅内血管磁共振血管造影（MRA，飞行时间3D）中经常观察到的诊断陷阱，即双侧横窦之一缺如。50例患者接受了采用TOF 3D（FISP）和TOF 2D（FISP）技术的颅内血管MRA检查。5例患者存在窦狭窄。MRA检查使用1.5T超导磁体和圆形头部线圈。所有患者均接受了在冠状面采集的FISP 2D序列（翻转角40°，重复时间40ms，回波时间12ms）以及在轴面采集的FISP 3D序列（翻转角15°，重复时间30ms，回波时间7ms）的磁共振血管造影检查。在FISP 2D序列能正确显示整个窦汇的患者中，FISP 3D序列总能显示上矢状窦，而右侧横窦在84.4%（38/45）的病例中可见，左侧横窦在24.2%（11/45）的病例中可见。在窦汇狭窄的患者中，FISP 3D序列相对于FISP 2D序列显示出2例假阳性病例。结果的统计学分析（McNemar检验）表明，在检测双侧横窦方面，2D和3D序列之间的差异具有统计学意义：右侧横窦p<0.01，左侧横窦p<0.001。在颅内血管研究（TOF 3D技术）中，双侧横窦之一缺如提示存在诊断陷阱；3D和2D序列联合使用可解决这一诊断问题。
