Kraniyal Lezyonlarda Gradient T2*- Ağırlıklı Manyetik Rezonans Görüntülemenin Tanısal Katkısı

Year 2021, Volume: 3 Issue: 2, 74 - 80, 01.07.2021

Nurdan Göçgün Türkan İkizceli

https://doi.org/10.38175/phnx.915061

Abstract

Amaç: Manyetik rezonans görüntülemede sekanslarından “gradient recalled echo” diğer görüntüleme metotlarıyla görülemeyen mikro kanamaların ortaya konmasında önemli rol oynamaktadırlar. Bu çalışmada kanama harici diğer hastalarda gradient T2*-ağırlıklı sekansın tanıya katkısı sunuldu.
Gereç ve Yöntemler: Ocak 2018- Aralık 2019 tarihleri arasında tanısal amaçlı kraniyal manyetik rezonans görüntüleme yapılmış ve standart sekanslarına ek olarak gradient T2* içeren görüntülemeleri olan 47 hasta geriye dönük olarak çalışmaya dâhil edildi. Lezyonlar etyolojik nedenlerine göre üç grup altında sınıflandı; vasküler, kitle ve diğer nedenler. Lezyonların gradient sekanstaki lokalizasyonları, sayıları, boyutları, intensiteleri, post.kontrast bilgileri ve blooming artefaktının varlığı değerlendirildi.
Bulgular: 33’si erkek, 14’si kadın 47 olgunun yaş aralığı 27-93’ydi, ortalama yaş 58.32±16.67. Olgulardan 33’ü (%70) vasküler nedenli, 6’sı kitle (%13) ve 8’i “diğer” (%17) grubundaydı. Vasküler lezyonlar arasında hipertansif ve amiloid mikroanjiopati, serebrovasküler olay, kanama, venöz tromboz, vasküler malformasyon, vasküler malformasyon-kanama yer almaktaydı. Kitlelerin 3’ü hemorajik metastaz, diğerleri kalsifik menenjiom, oligoastrositom, hemanjioblastomdu. ‘Diğer’ grubunda ise infeksiyon (tüberküloz granulomları, toxoplazma), inme taklitçisi (laminar nekroz, kalsifikasyon), hipofiz apopleksisi, FAHR sendromu ve metakromatik lökodistrofi, nefrotoksisiteye bağlı madde birikimi vardı. Gradient T2* sekans bulguları olgulara tanı koydurucu veya tanıyı güçlendirici etkisi olmuştur.
Sonuç: Gradient T2*-Ağırlıklı görüntüleme vasküler hastalıklardaki bilinen değeri yanında non-vasküler santral sinir sistemi hastalıklarında da tanıyı güçlendirmektedir.

Keywords

kraniyal lezyonlar, nöroradyoloji, Gradient T2*- Ağırlıklı görüntüleme

Thanks

Sağlık Bilimleri Üniversitesi Nöroloji Bölümü'nden Doç.Dr. Birgül Baştan'a katkılarından dolayı teşekkür ederiz.

Diagnostic Contribution of Gradient T2*-Weighted Magnetic Resonance Imaging in Cranial Lesions

Abstract

Objective: “Gradient recalled echo” sequences on magnetic resonance imaging (MRI) plays an important role in detecting micro bleeding that cannot be seen by other imaging methods. In this study, we aimed to show that the contribution of gradient T2*-weighted sequence in other diseases except for hemorrhage to diagnosis.
Materials and Methods: Forty-seven patients who underwent diagnostic cranial MRI with gradient T2*-weighted sequence in addition to their standard sequences between January 2018 and December 2019 were included in the study retrospectively. Lesions were classified into three groups according to etiological reasons; vascular, mass, and others. Lesion localization, numbers, sizes, intensities, post-contrast information, and the presence of blooming artifacts were evaluated.
Results: The age range of 47 patients (33 men and 14 women) was 27-93, the mean age was 58.32±16.67. 33 (70%) of the cases were due to vascular causes, 6 of them were in the mass (13%) and 8 of them were in the "other" (17%) group. Vascular lesions included hypertensive and amyloid microangiopathy, cerebrovascular event, hemorrhage, venous thrombosis, vascular malformation, vascular malformation-hemorrhage. Three of the masses were hemorrhagic metastasis, others were calcific meningioma, oligoastrocytoma, hemangioblastoma. In the 'Others' group, there were infections (tuberculosis, toxoplasma), stroke (laminar necrosis, calcification), pituitary apoplexy, FAHR syndrome, metachromatic leukodystrophy, and substance accumulation due to nephrotoxicity. Gradient T2 * sequence findings were diagnostic or contributing to the diagnosis.
Conclusion: Besides its known value in Gradient T2*-weighted imaging in vascular diseases, it also contribute to the diagnosis in non-vascular central nervous system diseases.

Keywords

Gradient T2*-Weighted imaging, cranial lesions, neuroradiology

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