脑静脉窦血栓形成的临床及影像学特点

目的 探讨脑静脉窦血栓形成(CVST)的临床及影像学特点.方法 回顾性分析9例确诊的CVST患者的临床资料.结果 9例患者有不同程度的头痛、恶心、呕吐,5例癫(癎)发作,出现发热、视盘水肿、局灶性神经功能缺损及意识障碍各为3例.9例脑脊液检查显示压力明显增高,但常规生化均正常.影像学检查:8例行头颅CT检查,但均未能明确诊断;9例头颅MRI检查,早期显示受累静脉窦内及相关脑区斑片状、条索状长T1、长T2信号影;MRV检查示受累的静脉窦不显影或显影不清;慢性期MRI表现为T1、T2均为稍高信号条索状影;MRV示静脉窦显影,未完全再通时显示轮廓欠清.结论 CVST常见颅内压增高等非特异性临床表现,脑脊液压力增高而无常规生化异常;MRI出现静脉窦正常流空效应消失,代之以异常等或高信号影;MRV特征为受累静脉窦血流信号不规则或完全消失.

Clinical and imaging characteristics of cerebral venous sinus thrombosis

Objective To study the clinical and imaging characteristics of cerebral venous sinus thrombosis(CVST).Methods Clinical data of 9 cases with CVST were retrospectively analyzed.Results All patients had headache,nausea and vomiting; 5 patients had epilepsy; 3 patients had focal neurological deficits; 3 patients had fever; 3 patients had palilledema; 3 patients had disturbance of consciousness. CSF examination showed prominent high intracranial pressure, but conventional and biochemical examinations were normal. 8 patients did CT scan, but the diagnosis was not clear. All patients first MRI showed venous sinus and related brain areas long T1 and T2 signal; MRV showed that the involved venoussinus had non-visualized signal. MRI in chronic phase showed slightly higher T1 and T2 signal; MRV showed sinus enhancement.The outline of uncomplete reconalzation was unclear. Conclusions The common high intracranial pressure is unspecific sign and symptom of patients with CVST. CSF examination show that the intracranial pressure is prominent high, but conventional and biochemical examination are normal. MRI can show that the normal flow void of the dural sinus is disappeared, instead of abnormal high or equality intensities. The characters of CVST in MRV are those the blood flow signal of involved venous sinus be disappeared or showed anormalism.