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目的:研究颅内巨大蛇行动脉瘤(giant serpentine aneurysm,GSA)患者的影像学特征。方法:连续收集我院2010年3月~2014年3月经本院或外院CT和MRI/MRA诊断的GSA患者7例,总结患者的影像学特点,结合文献进行分析讨论。结果:GSA患者的影像学特点主要表现为:CT显示病灶为不均质高密度占位效应,可见周围脑组织水肿和蛋壳样钙化,CT增强扫描显示瘤壁略强化,相对低密度区均一强化。MRI主要表现为边界清楚、呈混杂信号的占位性病变,主要为不同强度短T1、长T2信号。MRI增强扫描可见厚壁的瘤壁有明显强化,内部血栓无强化,其内血流通道则显示为高信号。CTA和MRA可以较为清晰的显示颅内动脉蛇血管通道和走形。结论:GSA患者的影像学表现具有相对的特异性,CT/MRI扫描可作为其临床初步筛查和辅助诊断手段之一。
Objective: To study the imaging features of patients with giant serpentine aneurysm (GSA). Methods: Seven consecutive patients with GSA diagnosed by CT and MRI / MRA in our hospital from March 2010 to March 2014 were retrospectively reviewed. The imaging features of the patients were summarized and analyzed in the literature. Results: The imaging features of GSA patients mainly showed as follows: the lesions showed heterogeneous high-density space-occupying effect, showing edema and egg shell-like calcification in surrounding brain tissue. CT enhanced scans showed slight enhancement of the tumor wall and relatively low density area strengthen. MRI is mainly characterized by a clear boundary, occupying lesions were mixed signals, mainly of different intensity of short T1, long T2 signal. MRI enhanced scan shows thick wall of the wall was significantly enhanced, no enhancement of the internal thrombosis, the blood flow channel showed a high signal. CTA and MRA can be more clearly show the intracranial arterial snake vascular access and shape. Conclusion: The imaging findings of GSA patients are relatively specific. CT / MRI scan can be used as one of the primary screening and auxiliary diagnosis methods in GSA patients.