脑静脉窦和静脉血栓形成的影像学诊断与分析

目的 探讨脑静脉窦和静脉血栓形成(CVST)的影像特征及诊断体会.方法 回顾性分析28例CVST患者的影像学表现、影像诊断特征.结果 (1)CVST的CT及MRI影像学表现只有少数病例可见典型的"条索状"直接征象(3.57%);最常见的间接征象为非典型性的脑出血(50.00%)及脑梗死(CT:32.14%,MRI:39.29%),发病部位以双侧性较多(75.00%).(2)大部分CVST患者的磁共振静脉成像(MRV)或CT静脉血管成像(CTV)出现静脉窦连续性中断,充盈缺损区,完全性或虫蚀状改变等直接征象(CTV:100%,MRV:83.33%),还可出现远端静脉窦增粗及引流静脉扩张等间接征象.结论 CVST的CT及MRI常规影像学表现无明显特异性,而CTV和MRV影像学表现具有较高的特异性,若怀疑CVST应尽早行MRV或CTV检查以明确诊断.

The imaging diagnosis and analysis of cerebral venous sinus and vein thrombosis

Objective To discuss the iconography experience and feature of cerebral venous sinus and vein thrombosis(CVST).Methods To analyze the iconography manifestation and diagnosis feature of28 CVST patients retrospectively.Results(1)The"cord-like"imaging,which is the typical direct sign,only can be seen in a few of CT and MRI iconography of CVST patients(3.57%).The most common indirect sign is atypical cerebral hemorrhage(50.00%)and cerebral infarction(CT:32.14%,MRI:39.29%).The most common diseased site is bilateral(75.00%).(2)Most of CT venography(CTV)or magnetic resonance angiography venography(MRV)of CVST patients show the direct sign,which include the continuity of the cerebral venous sinus was interrupted,filling defect and completely or worm-eaten-like changes(CTV:100%,MRV:83.33%),and the indirect sign,which include the thickening of the distal venous sinus and the expansion of the draining vein.Conclusions There is no significant specificity in CT and MRI imaging of CVST patients.while the CTV and MRV images show high specificity.The MRV or CTV should be executed early to confirmed diagnosis if the patient is suspected of suffering from CVST.