MRI和MRV在脑静脉和静脉窦血栓诊断中的价值

目的探讨MRI和MRV对脑静脉和静脉窦血栓(CVST)形成的诊断价值。方法回顾性分析16例CVST患者的临床和影像学资料。结果受累的脑静脉和静脉窦有上矢状窦9例,横窦5例,直窦3例,乙状窦2例,大脑大静脉合并大脑内静脉2例。常规MRI可见受累静脉窦流空信号消失,静脉窦内信号高低不一,11例脑实质内出现静脉性脑梗死表现,其中4例合并出血。增强扫描15例静脉窦内出现充盈缺损及静脉窦壁强化表现,9例脑实质内出现脑回样强化。MRV表现为受累静脉窦部分或广泛高血流信号缺失、狭窄。结论MRI和MRV是诊断和随访CVST形成的最佳检查方法。

Value of MRI and MRV in the diagnosis of thrombosis of the cerebral veins and sinuses

Objective To investigate the diagnosis value of MRI and MRV for the cerebral venous and sinus thrombosis (CVST). Methods The clinical and imaging data were retrospectively analyzed in 16 cases of CVST. Results The involved cerebral veins and sinuses included superior sagittal sinus in 9 cases, transverse sinus in 5 cases, straight sinus in 3 cases, sigmoid sinus in 2 cases, Galen vein plus internal cerebral vein in 2 case. Conventional MRI showed the flow void signal of the venous sinus disappeared, instead abnormal signals were found. 11 cases had venous infarction in brain parenchyma, 4 cases of which were combined with hemorrhage. Gadolinium-enhanced MRI showed the filling defect in venous sinus and enhancement effect of sinus wall in 15 cases, and gyri-shape enhancement signal in brain parenchyma of 9 cases. The signs of dural sinus thrombosis on MRV included the lack of a typical high-flow signal from a sinus and stenosis. Conclusion MRI and MRV are the best choice in diagnosis and follow-up of CVST.