磁共振血管成像对脑静脉窦血栓形成的诊断和疗效评价

目的 探讨MR脑血管成像在脑静脉窦血栓(CVST)形成的诊断和疗效评价中的作用. 方法 回顾性分析北京大学深圳医院影像中心自2001年8月至2007年1月期间收治的12例CVST患者的影像学资料,所有病例均作常规SE序列和2D-TOF静脉成像(MRV),10例患者做DSA,8例患者做3D-TOF动脉成像(MRA).比较不同成像方法对CVST病变的显示情况. 结果 12例患者共显示34个CVST.SE序列显示9例17个,表现为静脉窦正常流空信号消失,出现异常信号.MRV显示11例32个,表现为正常静脉窦高信号消失或其内充盈缺损.DSA显示10例30个.MRA显示2例(2/8)脑动脉血管减少.MRV显示的病变静脉窦数日明显高于SE序列,病变检出的阳性率为93.3%(相对DSA).MRV示6例经导管内注药溶柃治疗后随访的患者大部分病变静脉窦恢复正常高信号,溶栓前MRA所示脑动脉血管减少的2例患者则显示动脉血管明显增多. 结论 MR脑血管成像在CVST的诊断和疗效评价中能发挥重要作用.

Value of magnetic resonance angiography and venography in the diagnosis and therapeutic effect assessment of cerebral venous sinus thrombosis

Objective To assess the value of two-dimensional time-of-flight (2D-TOF) magnetic resonance venography (MRV) and 3D-TOF MR angiography (MRA) in the diagnosis and therapeutic effect evaluation of cerebral sinus thrombosis (CVST). Methods Twelve patients with CVST underwent both conventional spin-echo (SE) sequence MRI and 2D-TOF MRV, and 10 of the patients also received examination with DSA and 8 received 3D-TOF MRA. The findings of CVST by these imaging modalities were compared in these patients. Results A total of 34 CVST lesions were found in these 12 patients. Conventional SE sequence MRI identified 17 CVST lesions in 9 cases, showing abnormal signals in the venous sinus and loss of normal blood flow signals. MRV detected 32 CVST lesions in 11 cases, shown as filling defects and loss of normal high signals in the venous sinuses. DSA displayed 30 CVST lesions in 10 cases, and MRV showed reduced number of the cerebral arteries in 2 of 8 cases. The detection rate of cerebral venous sinus was 93.3% by MRV. Most of the venous sinuses showed normal high signals in 6 patients after endovascular treatment, and the two patients with reduced cerebral artery shown by MRA showed markedly increased cerebral arteries after thrombolytic therapy. Conclusion MRV and MRA can be of important values in the diagnosis and therapeutic effect evaluation of CVST.