脑动静脉畸形病灶体积测量：Silent MRA与TOF-MRA比较
本研究回顾性纳入45例脑动静脉畸形患者，比较Silent MRA、TOF-MRA与3D-DSA对畸形血管团体积测量的准确性。Silent MRA测得平均体积为9.55mL，与3D-DSA的9.073mL相关性为0.976。结论认为Silent MRA体积测量与DSA相当，可用于治疗后随访评估。
要点
- Silent MRA测量畸形血管团体积与DSA相关性高，可用于体积随访。
- TOF-MRA可能低估畸形血管团体积，体积测量时需注意。
- 既往栓塞状态影响Silent MRA与TOF-MRA的体积测量准确性。
核心结论
- Silent MRA对脑动静脉畸形血管团体积的测量结果与3D-DSA相当，具有临床实用性。
- Silent MRA可用于畸形血管团体积测量和作为治疗后体积变化的随访工具。
研究设计与样本
- 回顾性研究，纳入45例确诊脑动静脉畸形且均接受Silent MRA、TOF-MRA与DSA检查的患者。
- 三种成像工具均采用标准化阈值方案进行血管团体积测量，以3D-DSA体积作为对照。
关键影像表现/征象
- Silent MRA与TOF-MRA均可显示脑动静脉畸形血管团并用于阈值法体积测量。
诊断标准与关键数值
- 3D-DSA测得平均血管团体积为9.073（SD，7.667）mL，Silent MRA为9.55（SD，7.814）mL，TOF-MRA为7.773（SD，7.11）mL。
- Silent MRA的血管团重叠体积显著高于TOF-MRA：0.775（SD，0.109）比0.538（SD，0.206），P=.00。
- TOF-MRA的绝对体积差异显著高于Silent MRA：0.196（SD，0.192）比0.114（SD，0.147），P=.005。
- Silent MRA与TOF-MRA的血管团重叠体积和绝对体积差异均与既往栓塞状态显著相关。
临床应用与阅片要点
- Silent MRA可作为脑动静脉畸形血管团体积测量方法，用于治疗前评估和选择治疗策略。
- 对已接受栓塞治疗的患者，使用Silent MRA或TOF-MRA测量血管团体积时需注意栓塞状态对测量准确性的影响。
- TOF-MRA测量血管团体积可能低于DSA，阅片报告中应注意可能低估。
局限性
- 本研究为回顾性设计，样本量为45例。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
BACKGROUND AND PURPOSE: Accurate cerebral arteriovenous malformation (CAVM) nidus volume measurement is important for evaluating treatment strategy and neurologic prognosis. This study aimed to compare the accuracy of silent MRA for measuring CAVM nidus volume with TOF-MRA and to analyze the clinical factors that may affect the nidus volume measurement.
MATERIALS AND METHODS: A total of 45 patients diagnosed with CAVM who received silent MRA, TOF-MRA, and DSA examinations were retrospectively enrolled. A standardized protocol was used for nidus volume measurement using thresholding by these three imaging tools.
RESULTS: The mean nidus volume measured by 3D-DSA, silent MRA, and TOF-MRA was 9.073 (SD, 7.667) mL, 9.55 (SD, 7.814) mL, and 7.773(SD, 7.11) mL, respectively. The linear correlation coefficient of the nidus volume was 0.976 (P < .001) and .966 (P < .001), respectively. Silent MRA was significantly higher than TOF MRA in nidus overlap volume (0.775 [SD. 0.109] versus 0.538 [SD. 0.206] P = .00), while TOF MRA was significantly higher than silent MRA in absolute volume difference (0.196 [SD. 0.192] versus 0.114 [SD. 0.147], P = .005). For both silent MRA and TOF-MRA, the nidus overlap volume and absolute volume difference were significantly associated with previous embolization status.
CONCLUSIONS: Nidus volume measurement by silent MRA is comparable with DSA and is practical. Silent MRA can be used for nidus volume measurement and as a follow-up tool for evaluating nidus volume change after therapy.
引用
- Dong, Wu, Hong, et al. Noninvasive Volume Measurement of Cerebral Arteriovenous Malformation Nidus: Silent MRA Compared with TOF-MRA. AJNR Am J Neuroradiol. 2026. PMID: 42235971. doi:10.3174/ajnr.A9370
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。