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脑静脉(窦)血栓形成的影像学特点
引用本文:孟强,董曼丽,陈文利,钟静玫,刘江,翟明,张金章,蒲传强,刘军,黄旭升,于生元,吴卫平,郎森阳. 脑静脉(窦)血栓形成的影像学特点[J]. 中国临床医学影像杂志, 2005, 16(5): 245-248
作者姓名:孟强  董曼丽  陈文利  钟静玫  刘江  翟明  张金章  蒲传强  刘军  黄旭升  于生元  吴卫平  郎森阳
作者单位:1. 云南省第一人民医院神经内科,云南,昆明,650032
2. 中国人民解放军总医院神经内科,北京,100853
摘    要:目的:探讨脑静脉(窦)血栓形成(CVST)的影像学表现。方法:回顾性分析61例CVST患者的头颅CT、MRI、磁共振静脉血管造影(MRV)及数字减影血管造影(DSA)表现。结果:分别有61、49及59例患者行头颅CT、MRI及DSA检查。6例(6/7)急性患者,CT存在直接和间接征象,而11例(11/13)亚急性与33例(33/41)慢性患者CT无异常。急性与慢性患者MRI主要表现为静脉窦内T1低信号、T2高信号,亚急性期主要是T1、T2高信号。随着病程延长,静脉性脑梗死发生率下降(3/6,5/11,6/32),但空蝶鞍的机率增加(0,1/11,10/32)。8例行MRV检查的患者,均发现静脉(窦)充盈缺损或中断。MRI结合MRV技术可对行MRI检查的49例患者中的35例进行确诊,但11例慢性与3例亚急性患者,CT、MRI(V)均未发现异常,行DSA检查才得以确诊。结论:对急性CVST而言,头颅CT是一种简单、有效的诊断方法;而对亚急性与慢性患者,MRI具有更高敏感度与特异性;MRV可快速、无创地诊断CVST。如果头颅CT、MRI、MRV仍不能明确诊断,应尽快行DSA检查,尤其是皮层静脉以及深静脉血栓形成患者。

关 键 词:脑栓塞和血栓形成  体层摄影术,X线计算机  磁共振成像
文章编号:1008-1062(2005)05-0245-04
收稿时间:2004-10-25
修稿时间:2004-10-25

Imaging characteristics of cerebral venous(sinus) thrombosis
MENG Qiang,Dong Man-li,CHEN Wen-li,ZHONG Jing-mei,LIU Jiang,Zhai Ming,ZHANG Jin-zhang,PU Chuan-qiang,LIU Jun,HUANG Xu-sheng,YU Sheng-yuan,WU Wei-ping,LANG Sen-yang. Imaging characteristics of cerebral venous(sinus) thrombosis[J]. Journal of China Clinic Medical Imaging, 2005, 16(5): 245-248
Authors:MENG Qiang  Dong Man-li  CHEN Wen-li  ZHONG Jing-mei  LIU Jiang  Zhai Ming  ZHANG Jin-zhang  PU Chuan-qiang  LIU Jun  HUANG Xu-sheng  YU Sheng-yuan  WU Wei-ping  LANG Sen-yang
Affiliation:MENG Qiang1,DONG Man-li1,CHEN Wen-li1,ZHONG Jing-mei1,LIU Jiang1,ZHAI Ming1,ZHANG Jin-zhang1,PU Chuan-qiang2,LIU Jun2,HUANG Xu-sheng2,YU Sheng-yuan2,WU Wei-ping2,LANG S en-yang2
Abstract:Objective: To discuss the imaging feature of cerebral venous(sinus ) thrombosis (CVST). Methods: The feature of CT, MRI, magnetic resonance venogra phy(MRV) and DSA in 61 cases with CVST were reviewed. Results: There were 61, 49 and 59 cases examined by CT, MRI and DSA respectively. In the acute phase, 6/7 cases showed the direct and indirect CVST signs by CT scanning, but 11/13 subacu te and 33/41 chronic patients had no abnormality. In the acute and chronic phase , thrombosis in the sinus appeared as hypointense in T1- and hyperintense in T2- weighted spin-echo images. In the subacute phase, the thrombosis became hyperint ense in T1- and T2-weighted spin-echo images. As the disease progressed, venous infarction decreased, but the empty sella turcica increased. MRI and MRV togethe r provided the diagnosis of CVST in 35/49 cases. In 11 chronic and 3 subacute pa tients whose CT and MRI(V) were normal, DSA made the diagnosis of CVST. Conclusi on: CT is a simple and effective method to diagnose acute CVST. MRI is sensitive and exceptional to the diagnosis of CVST. MRV can evaluate venous and sinus thr ombosis quickly and non-invasively. If CT, MRI and MRV can not make a clear diag nosis, the patient need a DSA inspection, especially for cortex and deep venous thrombosis.
Keywords:cerebral embolism and thrombosis  tomography   X-ray computed  mag netic resonance imaging  
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