320排动态容积CT在脑静脉窦血栓形成诊断中的应用

目的评价320排动态容积CT在脑静脉窦血栓形成（CVST）诊断中的应用价值。方法对12例CVST患者行320排头颅CT一站式检查，包括CT平扫、各期增强，然后将动态容积原始数据重建出容积图像，传入Vitreafx工作站，处理获得动脉期、动静脉混合期、静脉期及静脉窦期血管重建图像。结果12例CVST中10例累及多个静脉窦，2例为单个静脉窦受累。CVST直接征象有：CT平扫显示为“高密度三角征”（3例），“带征”（1例），CT增强显示“空三角征”（4例）；间接征象有：血栓形成部位邻近脑组织水肿（3例），静脉性脑梗死（4例），静脉性脑出血（5例）。12例CVST中静脉期图像均可见静脉窦不规则狭窄或闭塞，可见特征性的“空槽征”。12例患者的CVST均经3D—DSA证实。结论与传统影像学检测方法比较，320排动态容积cT检查无创伤、时间短和辐射剂量少，对CVST的诊断具有重要价值。

Application of 320-slice dynamic volume CT to diagnosis of cerebral venous sinus thrombosis(report of 12 cases)

Objective To evaluate the value of 320-slice dynamic volume CT to the diagnosis of cerebral venous sinus thrombosis （CVST）. Methods Twelve patients with CVST were examined with 320-slice dynamic volume CT, including unenhanced and enhanced brain CT scanning, and CT angiography. Vascular images were reconstructed through the workstation. Three-dimensional digital subtraction angiography （3D-DSA） examination was performed also in all the patents. Results CVST was definitely diagnosed by 320-slice dynamic volume CT in 12 patients, of whom, 10 suffered from multiple venous sinuses thrombosis and 2 from the single venous sinus thrombosis. The direct signs of CVST included ＂ense triangle sign＂ in 3 cases, ＂cord sign＂ in 1 case shown by unenhaneed CT scanning and ＂empty triangle sign＂ in 5 cases shown by the enhanced axial CT scanning. Indirect signs of CVST included cerebral edema in 3 eases, cerebral infarction in 4 cases and cerebral hemorrhage in 5 cases. The irregular stenosis or occlusion of venous sinuses was found by CT-DSA in all the patients. The diagnostic ＂empty groove sign＂ was observed. CVST was confirmed by 3D-DSA in all the patients. Conclusion The images from 320-slice dynamic volume CT with wide area detector and non-helical scanning mode, which have excellent quality and less artifacts, have important value to the diagnosis of CVST.