脑静脉窦血栓MRI增强扫描及MRV影像诊断价值

目的探讨脑静脉窦血栓形成(CVST)的影像及诊断价值。方法本研究分析2009年7月至2012年2月在第四军医大学西京医院35例CVST患者的MRI平扫、MRV及MRI增强扫描的直接征象,MRI增强扫描表现为静脉窦内低信号三角征(直接征像),磁共振轴位上,静脉窦呈高信号明显强化,而与腔内血栓无强化,类似三角形,MRI平扫表现为T1为等信号、T2等低信号直接征像。MRV表现为受累静脉窦不显影或者局限性信号缺失、中断。结果本组35例(81.2%)为中青年患者,均行MRI平扫、MRV及MRI增强扫描,其中MRI增强扫描中有31例出现"三角征",29例患者MRV呈阳性,5例MRI平扫呈阳性;由此可见,MRI增强扫描"空三角征"的出现率极高,达到88.6%。结论头部MRI、MRV、增强扫描检查能显示CVST脑组织直接和间接受累征像,本研究得出头颅MRI增强扫描+MRV成像可作为诊断CVST的首选检查,且其联合扫描是CVST最敏感的检查方法,也是最佳影像学检查方法。三种检查联合扫描复查能动态观察病情及反映疗效。

The diagnostic value of MR enhancement scan and MRV on dural sinus thrombus

Objective To explore the diagnostic value of imaging on cerebral vein and sinus thrombosis（CVST）.Methods The plain MRI scan,magnetic resonance venography（MRV）,MRI enhancement scanning of 35 patients with CVST admitted to Xijing Hospital,Fourth Military Medical University were analyzed retrospectively.Hypointensity empty triangle sign（direct imaging） of venous sinus thrombus were found on brain MRI enhancement scanning.The vein and sinus were obviously enhanced,but the intra-cavity thrombus were non-enhanced,similar to the triangle.The venous sinus thrombus showed isointensity on T 1 by the plain MRI scan,and MRV showed that involved venous sinus was non-visualized or localized signal missing and interruption.Results The youth patients accounted for 81.2% of all the patients,which scanned by plain MRI scan,MRV,and MRI enhancement scanning.Thirty-one showed the hypointensity triangle sign on enhancement scan,29 displayed the positive reactivity on MRV,and 5 displayed the positive reactivity on plain MRI scan.So the detection rate of CVST by MRI enhancement scan was 88.6%.Conclusion MRI,MRV and enhancement scan show the CVST-involved sings of brain tissues.Head MR enhancement scan combined with MRV is the priority for CVST diagnosis and is also regarded as the best and the most susceptible method.The three scanning tricks can reflect the illness and the curative effect directly.