ojrdrtОнкологический журнал: лучевая диагностика, лучевая терапияJournal of oncology: diagnostic radiology and radiotherapy2587-75932713-167XНЕКОММЕРЧЕСКОЕ ПАРТНЕРСТВО «ОБЩЕСТВО ИНТЕРВЕНЦИОННЫХ ОНКОРАДИОЛОГОВ»10.37174/2587-7593-2018-1-3-49-57ojrdrt-39Research ArticleЛУЧЕВАЯ ДИАГНОСТИКАDIAGNOSTIC RADIOLOGYИмпульсная последовательность SWI/SWAN в МРТ-диагностике микрокровоизлияний и сосудистых микромальформацийPulse Sequence SWI/SWAN in Diagnosis of Microhemorrhage and Cerebral Vascular MicromalformationsПронинИ Н.ProninI. N.pronin@nsi.ruЗахароваН. Е.ZakharovaN. E.ФадееваЛ. М.FadeevaL. M.pronin@nsi.ruПронинА. И.ProninA. I.ШульцЕ. И.ShultsE. I.БаталовА. И.BatalovA. I.Национальный медицинский исследовательский центр нейрохирургии им. акад. Н.Н. Бурденко Минздрава РФРоссияN.N. Burdenko National Medical Research Center of NeurosurgeryRussian FederationНациональный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава РФРоссияN.N. Burdenko National Medical Research Center of NeurosurgeryRussian FederationНациональный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава РФРоссияN.N. Blokhin National Medical Research Center of OncologyRussian Federation201830092018134957Copyright © Пронин И.Н., Захарова Н.Е., Фадеева Л.М., Пронин А.И., Шульц Е.И., Баталов А.И., 20182018Пронин И.Н., Захарова Н.Е., Фадеева Л.М., Пронин А.И., Шульц Е.И., Баталов А.И.Pronin I.N., Zakharova N.E., Fadeeva L.M., Pronin A.I., Shults E.I., Batalov A.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.oncoradjournal.ru/jour/article/view/39

Диагностика микрокровоизлияний в вещество головного мозга с помощью КТ и рутинной МРТ в большинстве случаев затруднена или даже невозможна. Появление новых технологий в МРТ позволило существенно повысить выявляемость микрокровоизлияний, тем самым более точно определять количественные характеристики и распространение микрокровоизлияний в структурах головного мозга. К таким технологиям можно отнести импульсную последовательность, взвешенную по магнитной восприимчивости – SWI/SWAN. Эта технология оказалось более чувствительной в определении микрокровоизлияний, чем стандартная T2*-взвешенная импульсная последовательность в МРТ. Мы ретроспективно оценили возможности SWAN-импульсной последовательности в визуализации микрокровоизлияний, вызванных различными причинами (гипертонической микроангиопатией, амилоидной микроангиопатией, последствиями легкой и тяжелой черепно-мозговых травм (ЧМТ) и др.). Мы сравнивали возможности рутинной КТ и стандартной 2D T2 *-взвешенной МР-импульсной последовательности с результатами, полученными при использовании SWAN-технологии. Полученные результаты наглядно свидетельствуют о высокой чувствительности и точности в определении локализации, количества и распространении микрокровоизлияний при использовании SWAN по сравнению с КТ и стандартным МРТ-протоколом, включающим 2D T2 *-взвешенный режим. В связи с этим мы рекомендуем добавление импульсной последовательности SWI/SWAN в протокол первичной МР-диагностики при исследовании головного мозга.

Conventional neuroimaging techniques (MRI, CT) have difficulties in brain microhemorrhage diagnosis. Application of new MRI modalities has significantly improved detection and qualitative assessment of microbleedings in different brain regions. Susceptibility weighted imaging (SWI or SWAN) refers to such technologies. SWI (or SWAN) has been more sensitive in microhemorrhages detection compared with conventional T2 * pulse sequence. We retrospectively assessed the ability of SWAN pulse sequence in detection of brain microhemorrhages caused by different reasons (hypertensive microangiopathy, amyloid microangiopathy, mild and severe traumatic brain injury, etc.). We compared the obtained SWAN results with conventional 2D T2 *-weighted pulse sequence and CT data in cases when it was possible to do. The results have demonstrated high sensitivity and accuracy of SWAN in assessment of location, amount and distribution of brain microhemorrhages compared with CT and conventional MRI, including 2D T2 *-weighted imaging. We recommend to include SWI (or SWAN) pulse sequence into the primary brain MRI protocol in patients with different pathologies.

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The authors declare that there are no conflicts of interest present.