脑静脉窦血栓形成的MR诊断及MRV的应用

目的探讨脑静脉窦血栓形成（cerebral venous sinus thrombosis, CVST）的MR征象及磁共振脑静脉系血管成像（magnetic resonance venography, MRV）的技术方法。方法4例脑静脉窦血栓形成患者，男2例，女2例，年龄32～51岁，全部经常规MRI及MRV检查，2例患者行增强扫描，全部患者经DSA检查证实。结果4例患者平扫SE序列均可见静脉窦内正常流空信号消失，代之以异常等或高信号。出血性脑梗死3例；广泛脑肿胀及脑水肿1例。MR增强可见静脉窦异常低信号或闭塞；对比增强磁共振血管造影检查（contrast enhanced magnatic resonance venography, CE-MRV）见受累静脉窦腔内血流信号不规则或信号完全消失。结论MRI结合3D-CE-MRA是诊断脑静脉窦血栓形成的有效手段。

MR findings and application of MRV in intracranial venous sinus thrombosis

Objective To discuss the MR feature of cerebral venous sinus thrombosis and to investigate the technique methods of intraeranial MR venography （MRV）. Methods 4 cases of cerebral venous sinus thrombosis were discussed including 2 cases of male and 2 cases of female, aged from 32 to 51 years old, MRI and MRV were performed in all 4 cases, Gd-DTPA enhancement scans were performed in 2 cases. The diagnosis of 4 cases were proved by DSA images. Results In all 4 cases, thrombosis in the sinus showed hyper or isointensity without flow void signin SE sequence. Hemorrhage infarction was seen in 3 cases. Brian swelling and edema was seen in 1 case. Hypointense lesion in the sinus was found on contrast MRI. The signs of cere bral venous sinus thrombosis in 3D-CE-MRV included loss of vascular flow signal or a frayed appearance of the venous sinus. Conclusions 3D-CE-MRV combined with MRI are effective methods in the diagnosis of cerebral venous sinus thrombosis.