脑静脉窦血栓形成的MRI诊断(附15例分析)

目的 :探讨MRI对脑静脉窦血栓 (VST)的诊断价值。方法 :回顾性分析 15例VST患者的完整临床和影像学资料。全部行MR检查 ,其中 9例行增强扫描 ,8例行脑静脉MRA检查 ;12例曾行CT检查 ,其中 4例行增强扫描。结果 :上矢状窦受累 12例合并横窦血栓 11例 ,窦汇 7例、乙状窦 6例、下矢状窦、直窦受累 6例 ,海绵窦受累 1例。血栓在T1WI上均呈等、高不均匀信号 ,并出现脑组织肿胀 ,脑沟变浅 ,脑回模糊 ,在T2 WI上信号因发病时间不同而有所不同 ,8例T2 WI脑实质无异常信号 ,7例T2 WI脑实质出现异常信号。增强扫描 9例全部出现静脉异常强化。MRA表现为受累静脉窦信号较淡、边缘模糊且不规则的血流信号或血流信号完全消失。 12例CT检查中 2例见“空delta征” ,4例表现为梗塞、出血等不典型改变。结论 :MRI是诊断VST的首选检查方法 ,并对VST的预后评价有重要意义

MRI diagnosis of cerebral venous sinus thrombosis(analysis of 15 cases)

Objective:To investigate the diagnosic value of MRI for cerebral venous sinus thrombosis(VST).Methods:The complete clinical and imaging data were retrospectively analyzed in 15 cases proved VST.MRI were performed in all the 15 cases,in which Gd DTPA enhancement in 9 cases,cerebral venous MRA studies in 8 cases.CT were performed in 12 cases with 4 enhancement studies.Results:The superior sagittal sinus were affected in all the 15 cases,combined transverse sinus thrombosis in 11 cases,sinus confluence in 7 cases , sigmoid sinus in 6 case , inferior sagittal sinus,straight sinus were affected in 6 cases , cavernous sinus in 1 cases. The signal intensity of thrombus was heterogenous iso to hyperintense on T 1WI and different because of onset time on T 2WI,brain swelling,sulcus shallowing and gyrus blurring were also noted. 8 cases didn't have abnormal signal in brain tissue on T 2WI,whereas 7 cases did.Abnormal venous enhancement were found on contrast enhancement in all 9 cases.The signs of VST on MR venography included loss of vascular flow signal or a frayed appearance of the venous sinus.The"empty delta" sign were found in 2 cases of all 12 CT studies , and atypical changes such as infarction ,hemorrhage were found in 4 cases.Conclusion:MRI is the first choice for diagnosis of VST,and has crucial significance for prognosis appraisal.