慢性硬膜下血肿脑膜中动脉的MR血管成像特征及其与预后的关系

牛胤; 陈家飞; 蒋周阳; 鲜继淑; 朱刚; 冯华; 陈志

doi:10.16016/j.2097-0927.202112224

您当前的位置：

首页 >

文章列表页 >

慢性硬膜下血肿脑膜中动脉的MR血管成像特征及其与预后的关系

临床医学 | 更新时间：2026-01-09

- 慢性硬膜下血肿脑膜中动脉的MR血管成像特征及其与预后的关系
- Features of MR angiography of the middle meningeal artery in chronic subdural hematoma and its relationship with prognosis: clinical report of 41 cases
- 陆军军医大学学报 2022年44卷第12期页码：1249-1254
- 作者机构：
  
  1.400038 重庆，陆军军医大学(第三军医大学)第一附属医院：神经外科，全军神经外科研究所，精准神经医学与神经再生修复重庆市重点实验室
  2.400038 重庆，陆军军医大学(第三军医大学)第一附属医院：放射科
- 作者简介：
  
  [陈志, E-mail: southwesthpcz@163.comCHEN Zhi, E-mail: southwesthpcz@163.com
- 基金信息：
  
  陆军军医大学优秀人才库重点扶持项目(xz-2019-505-002);陆军军医大学科技创新能力提升专项(2019XYY12)
- DOI：10.16016/j.2097-0927.202112224
  中图分类号： R445.2;R322.121;R651.15
- 收稿：2021-12-25，
  
  修回：2022-01-15，
  
  纸质出版：2022-06-30
- 稿件说明：
移动端阅览
牛胤, 陈家飞, 蒋周阳, 等. 慢性硬膜下血肿脑膜中动脉的MR血管成像特征及其与预后的关系[J]. 陆军军医大学学报, 2022,44(12):1249-1254.

Yin NIU, Jiafei CHEN, Zhouyang JIANG, et al. Features of MR angiography of the middle meningeal artery in chronic subdural hematoma and its relationship with prognosis: clinical report of 41 cases[J]. Journal of Army Medical University, 2022, 44(12): 1249-1254.
牛胤, 陈家飞, 蒋周阳, 等. 慢性硬膜下血肿脑膜中动脉的MR血管成像特征及其与预后的关系[J]. 陆军军医大学学报, 2022,44(12):1249-1254. DOI： 10.16016/j.2097-0927.202112224.

Yin NIU, Jiafei CHEN, Zhouyang JIANG, et al. Features of MR angiography of the middle meningeal artery in chronic subdural hematoma and its relationship with prognosis: clinical report of 41 cases[J]. Journal of Army Medical University, 2022, 44(12): 1249-1254. DOI： 10.16016/j.2097-0927.202112224.

摘要

目的

通过磁共振血管成像(MR angiography，MRA)明确慢性硬膜下血肿(chronic subdural hematoma，CSDH)患者脑膜中动脉(middle meningeal artery，MMA)管径特征，以及MMA管径与CSDH患者预后的关系。

方法

采用回顾性匹配对照研究分析2014年5月至2021年5月我院收治的CSDH患者临床资料，在脑动脉三维时间飞越法(3D time of flight，3D TOF) MRA检查上测量CSDH患者MMA管径并与匹配的健康人进行对比，并对钻孔引流术后复发侧与非复发侧MMA管径进行比较。

结果

41例CSDH患者中56侧血肿侧MMA管径明显大于26侧非血肿侧MMA管径(

0.01)，并大于所匹配41例健康人82侧MMA管径(

0.01)，CSDH患者非血肿侧MMA管径也大于健康人MMA管径(

0.01)；11例双侧CSDH患者出血较多侧与出血较少侧MMA管径比较无明显差异(

=0.18)；钻孔引流术后复发9例12侧MMA管径明显大于非复发14例18侧MMA管径(

0.01)。

结论

CSDH患者出血侧MMA明显增粗，钻孔引流术后复发侧MMA增粗更明显，提示MMA管径与CSDH的发生及发展有关，并与CSDH患者预后相关。

Abstract

Objective

To determine the vascular diameter of middle meningeal artery (MMA) in patients with chronic subdural hematoma (CSDH) by magnetic resonance angiography (MRA)

and investigate its relationship with patient's prognosis.

Methods

Clinical data of 41 CSDH patients admitted to our hospital from May 2014 to May 2021 were retrospectively collected and analyzed in this retrospective matched control study. The MMA diameter was obtained by 3D time-of-flight (3D TOF) MRA

and the results of CSDH patients were compared with those of matched healthy controls. After burr hole and drainage

the MMA diameters on the recurrent side were compared with those on the non-recurrent side.

Results

Among the 41 CSDH patients

the 56 MMA diameters on CSDH side were significantly larger than the 26 MMA diameters on non-CSDH side (

0.01)

and were larger than the 82 MMA diameters in 41 matched healthy subjects (

0.01). In addition

the MMA diameter on non-CSDH side of the 41 CSDH patients was also larger than that in healthy subjects (

0.01). There was no significant difference in MMA diameter between the CSDH side with larger bleeding amount and the CSDH side with less in the 11 bilateral

CSDH patients (

=0.18). After burr hole and drainage

the 12 MMA diameters in 9 recurrent cases were significantly larger than the 18 MMA diameters in 14 non-recurrent cases (

0.01).

Conclusion

In CSDH patients

the MMA on the CSDH side is significantly thickened

and it on the recurrent side is more obvious than that on the non-recurrent side after burr hole and drainage

suggesting that MMA diameter might be associated with the occurrence and development of CSDH and the prognosis of patients.

关键词

Keywords

references

YANG W Y, HUANG J. Chronic subdural hematoma: epidemiology and natural history[J]. Neurosurg Clin N Am, 2017, 28(2): 205-210. DOI: 10.1016/j.nec.2016.11.002.

LEE K S. History of chronic subdural hematoma[J]. Korean J Neurotrauma, 2015, 11(2): 27-34. DOI: 10.13004/kjnt.2015.11.2.27.

LEE K S. Natural history of chronic subduralhaematoma[J]. Brain Inj, 2004, 18(4): 351-358. DOI: 10.1080/02699050310001645801.

HASHIMOTO T, OHASHI T, WATANABE D, et al . Usefulness of embolization of the middle meningeal artery for refractory chronic subdural hematomas[J ] . Surg Neurol Int, 2013, 4: 104. DOI: 10.4103/2152-7806.116679.

BAN S P, HWANG G, BYOUN H S, et al . Middle meningeal artery embolization for chronic subdural hematoma[J ] . Radiology, 2018, 286(3): 992-999. DOI: 10.1148/radiol.2017170053.

LINK T W, BODDU S, PAINE S M, et al . Middle meningeal artery embolization for chronic subdural hematoma: a series of 60 cases[J ] . Neurosurgery, 2019, 85(6): 801-807. DOI: 10.1093/neuros/nyy521.

TAKIZAWA K, SORIMACHI T, ISHIZAKA H, et al . Enlargement of the middle meningeal artery on MR angiography in chronic subdural hematoma[J ] . J Neurosurg, 2016, 124(6): 1679-1683. DOI: 10.3171/2015.5.JNS1567.

DASH C, SINGLA R, GARG K, et al . Letter to the Editor: Enlargement of the middle meningeal artery[J ] . J Neurosurg, 2016, 125(6): 1613-1615. DOI: 10.3171/2016.6.JNS161517.

HIRAI S, YAGI K, HARA K, et al . Postoperative recurrence of chronic subdural hematoma is more frequent in patients with blood type A[J ] . J Neurosurg, 2021, 135(4): 1203-1207. DOI: 10.3171/2020.7.jns202330.

TOI H, FUJⅡ Y, IWAMA T, et al . Determining if cerebrospinal fluid prevents recurrence of chronic subdural hematoma: a multi-center prospective randomized clinical trial[J ] . J Neurotrauma, 2019, 36(4): 559-564. DOI: 10.1089/neu.2018.5821.

KOLIAS A G, CHARI A, SANTARIUS T, et al . Chronic subdural haematoma: modern management and emerging therapies[J ] . Nat Rev Neurol, 2014, 10(10): 570-578. DOI: 10.1038/nrneurol.2014.163.

JIANG R C, ZHAO S G, WANG R Z, et al . Safety and efficacy of atorvastatin for chronic subdural hematoma in Chinese patients: a randomized ClinicalTrial[J ] . JAMA Neurol, 2018, 75(11): 1338-1346. DOI: 10.1001/jamaneurol.2018.2030.

CHON K H, LEE J M, KOH E J, et al . Independent predictors for recurrence of chronic subdural hematoma[J ] . Acta Neurochir (Wien), 2012, 154(9): 1541-1548. DOI: 10.1007/s00701-012-1399-9.

EDLMANN E, GIORGI-COLL S, WHITFIELD P C, et al . Pathophysiology of chronic subdural haematoma: inflammation, angiogenesis and implications for pharmacotherapy[J ] . J Neuroinflammation, 2017, 14(1): 108. DOI: 10.1186/s12974-017-0881-y.

HOLL D C, VOLOVICI V, DIRVEN C M F, et al . Pathophysiology and nonsurgical treatment of chronic subdural hematoma: from past to present to future[J ] . World Neurosurg, 2018, 116: 402-411. e2. DOI: 10.1016/j.wneu.2018.05.037.

NAKAGAWA I, PARK H S, KOTSUGI M, et al . Enhanced hematoma membrane on DynaCT images during middle meningeal artery embolization for persistently recurrent chronic subdural hematoma[J ] . World Neurosurg, 2019, 126(4): e473-e479. DOI:10.1016/j.wneu.2019.02.074.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

基于中国人群的雌激素受体表达新分层（低/中/高）可更精准地预测HR⁺/HER2^-早期乳腺癌患者的预后

转录因子TGIF1高表达胃癌的免疫抑制性微环境特征及临床意义分析

核仁磷酸蛋白1突变的分子异质性对急性髓系白血病预后的影响

5因子改良衰弱指数联合控制营养状态评分与不可切除肝癌患者介入治疗后总生存期的相关性分析

全身炎症反应指数联合临床病理参数预测宫颈癌复发的模型建立与验证