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海绵状血管瘤及脑血肿mri表现课件_1

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海绵状血管瘤及脑血肿MRI表现 海绵状血管瘤与脑血肿MRI表现 海绵状血管瘤 颅内海绵状血管瘤 与海绵状血管瘤
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单击此处编辑母版标题样 式 单击此处编辑母版副标题样式 * * 1 1 脑内血肿及海绵状血管瘤 2012.3.15 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 超急性期 血肿物理状态 未凝固 红细胞 未破裂 含氧血红蛋白 时间 出血后数分钟---十几分钟 MRI信号 仍保持液体信号特征 长T1长T2(黑白) With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 急性期 血肿物理状态 脱水凝固 红细胞 未破裂 脱氧血红蛋白 时间 出血后2天内 MRI信号 脱氧血红蛋白造成磁场不均匀T2缩短 长T1短T2(双黑) With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 亚急性早期 血肿物理状态 凝固 红细胞 未破裂 正铁血红蛋白 时间 出血后3-5天 MRI信号 正铁血红蛋白造成T1缩短 短T1短T2(白黑) With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 亚急性中期 血肿物理状态 凝固 红细胞 破裂 正铁血红蛋白 时间 出血后6-10天 MRI信号 正铁血红蛋白细胞外期 短T1长T2(双白) With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 亚急性中期 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 亚急性晚期 血肿物理状态 凝固 红细胞 完全破裂 正铁血红蛋白 时间 出血后10天---3周内 MRI信号 正铁血红蛋白细胞外期 短T1长T2(双白+黑环) With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 亚急性晚期 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 慢性期 血肿物理状态 液化 红细胞 破裂 含铁血黄素 时间 出血3周后 MRI信号 液体信号+黑环 长T1长T2(黑白+黑环) With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 临床脑内出血分期 § 临床按出血时间分5期 § 超急性期(<24小时) § 急性期(1-3天) § 亚急性早期(4-7天) § 亚急性晚期(8-14天) § 慢性期(2周以后) With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 小结---轮回(黑白颠倒) 黑白 双黑 黑白 +黑环 双白 +黑环 白黑双白 超急性期 急性期 亚急性早期 亚急性中期 亚急性晚期 慢性期 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society § 临床不符可能有以下几个原因 § 个体差异 § 出血时间难确定 § 病灶内有反复出血 § 病灶的大小有差别 § 场强的大小有差别 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 海绵状血管瘤 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 脑海绵状血管瘤 § 属血管畸形的一种 § 单发(75%)多发(25%) § 幕上(颞叶最多)幕下 § 薄壁海绵状血窦,其间无脑组织 § 无供血动脉和引流静脉 § 钙化、出血、含铁血黄素沉积、胶质增生 § 常缺乏脑水肿 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 病理与临床 § 海绵状血管瘤在病例上由扩张、衬有内皮的窦样 间隙构成,窦样间隙排列紧密,无正常脑组织间 隔,病变呈圆形或分叶状,几乎全部由瘤内出血 。 § 海绵状血管瘤约80%发生于幕上,最常见于额叶 、颞叶深部髓质区、皮髓交接区和基底节区,也 可发生于小脑、脑干和脊髓,约50%病例多发 § 常见症状为癫痫、头痛和局灶性神经功能障碍 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society § 临床表现: § 无症状体检发现 § 头痛、癫痫、局限性神经功能障碍 § 脑出血 § 影像学诊断: § MRI>CT>DSAX线平片 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society MRI表现 § 海绵状血管瘤在常规自旋回波序列像上显示为边 界清楚的混杂信号病灶,周围有完整的低信号含 铁血黄素环,病灶呈“爆米花”状,具有特征性。 § 病灶内含有不同阶段的出血是信号不均匀的原因 § 病灶在梯度回波序列像中显示尤为清楚,常为多 发低信号 § 增强呈水母头样强化 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 海绵状血管瘤为红色圆形或分叶状血管团,形似草 莓或桑葚,切面如海绵状 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 鉴别诊断 § 动静脉畸形 § 发育性静脉异常 § 毛细血管扩张症 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 动静脉畸形 § 在典型自旋回波序列上,表现为一团流空 、迂曲的血管团, § 有血栓形成或血管内血流速度较慢者,可 呈高信号 § MRA和MRV可以更好的显示 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 发育性静脉异常 § 又称静脉瘤 § 多位于脑深部白质、脑室前后角附近或小 脑 § 一般较小的静脉瘤在MRI上仅显示引流静 脉 § 增强扫描一般均有显著强化,且可见髓质 静脉和引流静脉 § 一般无占位效应和病灶周围的水肿 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 毛细血管扩张症 § 病变可见于脑和脊髓的任何部位,以脑桥 、小脑最为常见,也可位于其他,病灶多 发为其特点 § 常规自旋回波序列T1加权像和T2加权像无 异常表现 § 在梯度回波序列T2加权像上,病灶呈明显 低信号 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society 谢谢 With the improving quality of life as well as the ever-accelerating pace of life, the quality of people's food needs and rate also changing.In order to meet the needs of society
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