3D-CE MRA、2D-TOF MRA对颅内静脉窦血栓的诊断价值比较

目的比较3D—CEMRA和2D—TOFMRA对颅内静脉窦血栓的诊断价值。资料与方法8例经临床及影像学随访证实的颅内静脉窦血栓患者及8例健康志愿者分别行3D—CEMRA和2D—TOFMRA检查。由两名放射学医师共同回顾性阅片取得一致意见，病变组分别比较两种MRA技术单独应用MIP和MIP联合MPR、CPR及原始图像对血栓部位、血栓范围、窦腔闭塞及侧支静脉的检出率。对照组仅在MIP和原始图像上观察颅内静脉走行形态、信号强度。结果血栓共累及了20处颅内静脉窦，其中上矢状窦7处，窦汇区、左侧乙状窦及左侧横窦各2处，右侧横窦、右侧乙状窦各3处，右侧颈静脉球1处。在显示颅内静脉窦血栓范围、窦腔闭塞程度及侧支静脉方面，3D—CEMRA优于2D．TOFMRA（P值均〈0．01）。3D—CEMRA采用MIP联合MPR、CPR及原始图像优于单独采用MIP（P值〈0．01）。2D—TOFMRA采用MIP联合MPR、CPR及原始图像和单独采用MIP比较，二者并无明显差异（P值〉0．01）。结论对颅内静脉窦血栓的评价，3D—CEMRA优于2D—TOFMRA，多种后处理技术的联合应用能更好显示血栓的范围、窦腔闭塞的程度和侧支静脉循环。

A Comparative Study with 2D-TOF MRA and 3D-CE MRA in the Evaluation of the Intracranial Dural Sinus Thrombosis

Objective To compare the diagnostic value of 2D-TOF MRA and 3D-CE MRA in the evaluation of intracranial dural sinus thrombosis.Materials and Methods 8 patients with dural sinuses thrombosis proved by clinical data and imaging follow up, 8 healthy volunteers were examined with 3D-CE MRA and 2D-TOF MRA. Two radiologists in consensus retrospectively compared the maximum intensity projection images (MIP), and combined with multiplanar reconstructed images (MPR), curved planar reconstructed images (CPR) and source images at 3D-CE MRA in patients with those obtained at 2D-TOF MRA. Visualization of the site and extent of thrombosis, degree of occlusion and collateral veins were recorded. The visualization of normal intracranial venous structures and intensity in control group were also recorded.Results Of 20 thrombosis in 8 patients, 7 were located in the superior sagittal sinus, 2 in the torcular Herophili, 2 in the left transverse sinus and sigmoid sinus respectively, 3 in the right transverse sinus and sigmoid sinus respectively, and 1 in the right jugular bulb. Overall, 3D CE MRA provided a superior visualization of the extent of thrombosis, degree of occlusion and collateral veins than do 2D-TOF MRA (P<0.01,respectively). At 3D-CE MRA, MIP images combined MPR, CPR and source images were superior to only using MIP images (P<0.01,respectively), while 2D-TOF MRA, MIP images combined MPR, CPR and source images had not statistical difference to only using MIP images (P>0.01,respectively).Conclusion 3D-CE MRA is superior to 2D-TOF MRA for the evaluation of the intracranial sinus thrombosis, in which the combination of multiple postprocessing display modalities can provide better visualization of the extent of thrombosis, degree of occlusion and collateral veins drainage.