脑静脉窦血栓形成的MRI和MR静脉成像表现特征

目的探讨MRI和MR静脉成像(MRV)在脑静脉窦血栓形成中的诊断特征。材料与方法 14例脑静脉血栓形成患者都经MRI 平扫和2D-PC法MRV。结果 14例脑静脉血栓形成中,MRI SE序列确诊11例,3例急性早期MRI平扫漏诊,后经MRV确诊。MRI表现静脉窦内短T1、长T2信号,血栓形成的静脉窦闭塞、充盈缺损。结论 MRI与MRV联合检查是诊断CVST的一种最佳方法,MRV是当前无创性、准确、敏感、理想的诊断脑静脉窦血栓形成的重要补充方法。     

颅内静脉及静脉窦血栓形成的诊治

颅内静脉及静脉窦血栓形成是脑血管病中的一种特殊临床类型 ,由 Ribe于 182 5年首次报道。在青壮年脑卒中患者约占 1%～ 2 % [1 ] ,可累及皮层静脉 ,静脉窦或二者均受累 ,单独的脑静脉血栓形成罕见 ,大多数由静脉窦血栓发展而来。男女发病率之比为 1∶ 2 .2 9。男性发病率各年龄组相等 ,6 1%的女性患者以 2 0～ 30岁多见 ,常有口服避孕药和妊娠史 [2 ] 。过去颅内静脉及静脉窦血栓形成临床诊断十分困难 ,容易漏诊或误诊。近年来 ,随着高分辨放射影像技术应用 ,使非典型表现的颅内静脉及静脉窦血栓形成较易诊断 ,从而减少了并发颅内高压及血…     

脑静脉血栓形成影像学诊断与误诊原因分析(附27例报告)

目的探讨计算机体层摄影(CT)、磁共振成像(MR)及数字减影血管造影术(DSA)对脑静脉血栓形成的诊断价值。方法 对我院2000～2010年经CT、MR、DSA和病理学诊断证实的27例脑静脉血栓形成临床资料进行回顾性分析。27例均行头部MRI检查,19例行MRV检查,21例行CT检查,15例行DSA检查。结果本组19例首次影像学检查确诊,8例误诊。误诊病例中7例行MRV或DSA检查确诊,1例死亡后尸检确诊。本组单纯脑深静脉血栓5例,单纯静脉窦血栓14例,脑深静脉血栓并静脉窦血栓8例。影像学直接征象为脑静脉内血栓,间接征象主要为水肿及静脉性梗死。结论 CT、MR及DSA检查对脑静脉血栓形成有一定诊断价值,需各检查结合,仔细分析鉴别,提高诊断率。     

脑静脉（窦）血栓形成的MRI和MRV诊断价值

目的探讨脑静脉血栓（CVT）和静脉窦血栓（CVST）形成磁共振成像（MRI）和磁共振静脉系成像（MRV）的特征。方法回顾性分析经磁共振诊断和临床治疗的58例脑静脉（窦）血栓病人的资料。全部有MRI平扫,其中39例有2DPC法MRV成像,观察脑静脉窦、脑静脉内和脑实质内信号改变。结果脑静脉窦血栓49例：单独静脉窦血栓31例,8例合并浅静脉血栓,其中3例合并出血;4例合并脑深静脉血栓;6例同时合并深、浅静脉血栓。单独脑深静脉血栓9例。结论 MRI结合MRV是诊断脑静脉（窦）血栓首选和最有效而又无损伤的检查方法。     

脑静脉窦血栓形成16例误诊分析

脑静脉血栓形成（cerebral venous thrombosis，CVT）是发生在颅内静脉系统包括静脉窦、大脑深静脉、大脑浅静脉的一种少见、特殊的血栓栓塞性疾病，临床表现各异，常易误诊及漏诊。我院自2004～2007年3月收治脑静脉窦血栓形成患者16例，现将误诊原因分析如下。     

颅内静脉窦血栓形成33例临床分析

目的：总结颅内静脉窦血栓形成的临床特点、诊断及治疗方法。方法：回顾性分析33例颅内静脉窦血栓形成患者的临床资料。结果：33例患者中显效25例,有效6例,无效1例,死亡1例。出院后随访8个月～3 a,2例肢体瘫痪者一般情况良好,余均恢复正常,均未再次发生脑静脉系统血栓。结论：颅内静脉窦血栓形成病因多样,头痛为常见或唯一症状;影像学检查有助于疾病的诊断,早期诊断及规范化治疗者预后良好。     

15例颅内静脉及静脉窦血栓形成的护理

颅内静脉系统血栓形成(cerebral venous thrombosis,CVT)是由多种疾病所致的脑静脉回流受阻的一组血管疾病,包括颅内静脉窦和静脉血栓形成〔1〕。由于颅内静脉血栓发生部位、范围、程     

颅内静脉窦血栓形成60例临床表现和影像学特点

目的探讨颅内静脉窦血栓形成的临床表现和影像学特点以提高该病的诊断。方法对60例颅内静脉窦血栓形成患者的临床特点和影像学检查等客观资料进行总结,并结合文献对其临床特点、发病机制、诊断及鉴别诊断进行分析。结果本组患者多为急性、亚急性起病,临床表现复杂,多有头痛,可伴有恶心、呕吐、癫痫、偏瘫、视力障碍等症状。影像学既可表现为出血也可表现为缺血,49例（49/54）头颅MRV检查示颅内静脉窦血栓形成,27例患者头颅DSA检查均示一处或多处静脉窦狭窄、充盈缺损和显示不良。脑脊液多压力升高,脑电图可有轻度异常。予抗凝等对症支持治疗,预后良好。结论颅内静脉窦血栓形成临床表现复杂多变,头痛是其主要表现,影像学MRV及DSA检查有助于该病诊断,及时治疗预后良好。     

围产期脑静脉血栓形成11例分析

脑静脉血栓形成（CVT）是发生在颅内静脉系统包括静脉窦、大脑深静脉，大脑浅静脉的一种少见特殊的血栓栓塞性疾病，妊娠和产褥期是最常见的危险因素，2003—01／2007—06我们先后经治11例，现分析如下。     

脑静脉窦血栓形成误诊1例分析并文献复习

目的:分析脑静脉窦血栓形成误诊原因及治疗方法。方法:应用核磁共振脑静脉造影(MRV)确定诊断,通过临床诊治过程,结合文献对脑静脉窦血栓形成(cerebral venous sinus thrombosis,CVST)的病理学特征、临床类型、误诊原因及治疗进行探讨。结果:CVST是一种特殊类型的脑血管疾病,病因复杂、起病形式多样,临床表现缺乏特异性,头部CT特异性和敏感性不高,脑脊液检查正常,易造成误诊及漏诊。结论:CVST发病急、进展快、死亡率较高,MRV是诊断脑静脉窦血栓形成并检测疗效的首选影像学检查方法,抗凝治疗是一种安全有效的方法。     

Diagnosis and treatment of cerebral venous thrombosis

Dural sinus or cerebral venous thrombosis (CVT) is a frequently unrecognized cause of stroke affecting predominantly young women. Typical clinical signs include headache, visual problems and seizures. Both computed tomography and magnetic resonance venous angiography are suitable for the detection of CVT, although magnetic resonance angiography is more sensitive to detect small cortical venous thrombosis. Evidence for efficacy of initial treatment with heparin in acute CVT comes from two randomized placebo-controlled studies that together included 79 patients. Although not evidence-based, postacute treatment with oral anticoagulation is recommended for up to 12 months after CVT. Long-term anticoagulation is recommended only in patients suffering from a severe coagulopathy or with recurrent CVT.     

Magnetic resonance black-blood thrombus imaging can confirm chronic cerebral venous thrombosis: a case report and literature review

BackgroundCerebral venous thrombosis (CVT) is easily missed or misdiagnosed in clinical settings because of its high variability in terms of symptoms and radiological findings. Herein, we aimed to explore a promising modality for confirming presumed CVT in the hope to uncover its superior diagnostic performance to conventional imaging modalities.Case presentation: The patient complained of intolerable pain in her forehead and left eye. Her lumbar puncture opening pressure was 140 mmH₂O, and her cerebrospinal fluid composition was normal. No marked abnormalities were observed in routine brain images, including non-contrast computed tomography, magnetic resonance imaging, and contrast-enhanced magnetic resonance venography. However, chronic mural thrombi in the lumen of the left cortical veins, transverse/sigmoid sinus, and superior sagittal sinus were identified in magnetic resonance black-blood thrombus imaging (MRBTI) maps.ConclusionsMRBTI can be used to directly and non-invasively visualize thrombi, and may thus be a promising tool over alternative routine techniques for confirming the diagnosis of CVT.     

My headache does not get better when I lie down: spontaneous intracranial hypotension complicated by venous thrombosis

Two patients with spontaneous intracranial hypotension (SIH) subsequently developed cerebral venous thrombosis (CVT) when their headache lost its distinctive orthostatic characteristic. In addition to typical MRI features of tonsillar descent, subdural fluid collections, and diffuse pachymeningeal enhancement, hyperintense thrombi were detected in the dural sinuses, and filling defects on magnetic resonance venography. Knowledge of the typical neuroimaging features of SIH and CVT and change in headache characteristics are important for prompt diagnosis and treatment.     

Cerebral venous thrombosis in young adults: 2 Case reports

Cerebral venous thrombosis (CVT) is a disease with multiple known etiologies that present with a remarkably wide spectrum of clinical signs and symptoms. We present a case of a 34-year-old man with a history of meningeal symptoms for 1 week after receiving a lumbar injection for lower back pain. He subsequently developed dense right hemiplegia and global aphasia. Head magnetic resonance imaging revealed superior sagittal sinus thrombosis. The patient was started on intravenous heparin but deteriorated neurologically. Urokinase infusion directly into the superior sagittal sinus was performed, with striking functional and neurologic improvement. Lupus anticoagulant was positive. We also present the case of a 24-year-old pregnant woman who developed an acute onset of meningeal symptoms and resultant left hemiparesis. Head magnetic resonance angiography revealed thrombosis of right transverse and sigmoid sinuses. Protein S deficiency was found. She was started on intravenous heparin, then enoxaparin, with improvement in symptoms. These cases demonstrate that CVT can be a cause of stroke in young patients with hypercoagability disorders, and a heightened awareness of CVT will promote optimal medical care and functional outcomes. Excellent functional recovery is likely with early recognition and treatment of the underlying etiology, as well as successful lysis of the clot.     

脑静脉窦及脑静脉血栓CT平扫表现及影像学诊断策略

目的：分析脑静脉窦/脑静脉血栓形成（CVST/CVT）CT平扫的影像学表现特征，以便提高CT平扫对CVST/CVT的早期认识，优化诊断方法，减少误诊。材料与方法：搜集拟诊为CVST/CVT病例25例的平扫及部分增强病例，经与MR与DSA等对照。重点回顾会诊前后血栓本身的CT平扫的直接征象及间接征象并进行对照，比较两者的结果。结果：CT平扫初诊血栓的直接征象的阳性率为13/25，阴性率为12/25，其中假阳性3例，假阴性8例。会诊后血栓阳性征象为21/25，阴性率为4/25，经统计学分析两者差别有显著性。而脑实质改变，会诊前检查的阳性率为20/25，阴性为5/20，而会诊后影像学阳性率为21/25，阴性为4/25，经统计学分析两者的差别无显著性。同时分析了CT平扫误诊原因及正确进行影像学检查的策略。结论：CVST/CVT CT初次平扫，大多都有血栓的直接征象及间接征象，正确认识这些征象，可以提示CVST/CVT的存在，并推荐立即行CTV检查来证实CT平扫的初步意见。     

脑静脉窦血栓形成的影像学检查及临床特征

目的:探讨脑静脉窦血栓形成(CVT)的临床特征及影像学特点,以寻求早期识别的征象及影像策略。方法:对62例经MR或/和DSA确诊为CVT的患者临床资料及影像学特点进行回顾性分析,并予抗凝治疗。结果:62例患者中有60例有非特异性头痛,其中56例行MRI+MRV检查确诊为CVT的有54例,32例经DSA检查均确诊为DVT。结论:CVT的临床表现缺乏特异性,MRI+MRV检查是诊断DVT的首选方法,DSA是诊断CVT的"金标准"。     

How to treat cerebral venous and sinus thrombosis

Summary. Cerebral venous and sinus thrombosis (CVT) is a rare form of thrombosis, with many different clinical manifestations. Better imaging techniques have greatly improved the diagnosis, but as a result of the paucity of controlled trials, choosing the optimal treatment for each patient often remains a challenge. Heparin is generally considered the mainstay of treatment, supported by data from a few small trials. More invasive treatment options are available, such as endovascular thrombolysis and – in more severe cases – decompressive hemicraniectomy. Furthermore, CVT is often accompanied by various neurological complications, such as seizures and intracranial hypertension, which require specific treatment. In this review we summarize the available treatment options for CVT and suggest which therapy should be reserved for which patients.     

Behcet's Disease: Presentation With Sagittal Sinus Thrombosis Diagnosed Noninvasively

The standard evaluation of patients with intracranial hypertension frequently does not reveal a discrete pathophysiologic process, leading in these cases to classification of the syndrome as "benign." We present a 35-year-old woman with a recent diagnosis of pseudotumor cerebri who presented with headache, emesis, and blurring of vision. Her symptoms were progressive despite two lumbar punctures that revealed normal cerebrospinal fluid under high pressure. Contrast and noncontrast CT scans were normal; both the cerebrospinal fluid and CT neuroimaging were thus consistent with benign intracranial hypertension. An MRI, however, supported the presence of sagittal sinus thrombosis, a finding which was confirmed by MR venography. Further workup for an underlying cause of sinus thrombosis disclosed symptoms and signs fulfilling the diagnostic criteria for Behcet's disease. Cerebral venous (or sinus) thrombosis should be considered in the differential diagnosis of intracranial hypertension. Behcet's disease, while extremely rare, should be considered as a potential cause of cerebral venous thrombosis. Magnetic resonance venography can serve as a useful diagnostic study in situations where confirmation or exclusion of sinus thrombosis is required.     

脑静脉及静脉窦血栓形成影像学诊断现状与进展

脑静脉血栓形成（CVT）是脑血管病的少见类型,临床表现缺乏特异性,易漏诊而常延误治疗。近年来,影像学新技术的出现使CVT的早期诊断率明显提高。本文就CVT的影像学诊断现状及进展进行综述。