颅内血管炎的诊断：磁共振成像及血管造影的作用
Diagnosing intracranial vasculitis: the roles of MR and angiography.
作者信息
Harris K G, Tran D D, Sickels W J, Cornell S H, Yuh W T
机构信息
Department of Radiology, University of Iowa College of Medicine, Iowa City 52242-1077.
出版信息
AJNR Am J Neuroradiol. 1994 Feb;15(2):317-30.
PURPOSE
To describe our experience with MR and angiography in diagnosing intracranial vasculitis and to test the hypothesis that MR can be used to screen for patients unlikely to have vasculitis.
METHODS
Ninety-two patients who had angiography with "exclude vasculitis" as the indication or who had angiography and a clinical diagnosis of vasculitis were identified. Angiograms of all 92 patients and the MRs of the 70 patients who had both studies were reviewed.
RESULTS
Eleven patients had intracranial vasculitis. Angiography showed characteristic changes in 8. MR, performed in 9 of 11 vasculitis cases, was significantly abnormal in all 9. Among 70 patients who had both studies, 19 had MR that was completely normal or showed only incidental findings. None of these 19 was diagnosed with vasculitis. The diagnostic yield of angiography performed to exclude vasculitis was only 6%.
CONCLUSIONS
Evaluation for intracranial vasculitis should include MR. A negative MR excludes intracranial vasculitis more definitively than does a negative angiogram and makes the likelihood of finding vasculitis with angiography negligible.
目的
描述我们在颅内血管炎诊断中运用磁共振成像（MR）和血管造影的经验，并验证MR可用于筛查不太可能患有血管炎患者的假设。
方法
确定了92例以“排除血管炎”为指征进行血管造影的患者，或进行了血管造影且临床诊断为血管炎的患者。回顾了所有92例患者的血管造影片以及70例同时进行了两项检查的患者的MR图像。
结果
11例患者患有颅内血管炎。血管造影显示8例有特征性改变。11例血管炎病例中的9例进行了MR检查，所有9例均有明显异常。在同时进行两项检查的70例患者中，19例的MR完全正常或仅显示偶然发现。这19例中无一被诊断为血管炎。为排除血管炎而进行的血管造影的诊断率仅为6%。
结论
颅内血管炎的评估应包括MR。与血管造影阴性相比，MR阴性更能明确排除颅内血管炎，并且使得通过血管造影发现血管炎的可能性微乎其微。
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