脑静脉窦血栓的磁共振诊断

目的 探讨磁共振的常规扫描序列和三维相位对比法MR静脉造影(3D-PC法MRV)对脑静脉窦血栓的诊断价值.方法 共收集34例临床确诊的脑静脉窦血栓病例,男15例,女19例.年龄1～71岁,中位年龄38岁.所有病例均行常规MR序列,3D-PC法MRV扫描；急性期(1～5天)脑静脉窦血栓7例；亚急性期(6～21天)18例,慢性期(＞21天)9例.结果 急性期脑静脉窦血栓信号T1WI以等低信号为主,T2WI以低信号为主；亚急性期T1 WI以高信号为主,T2WI呈低或高信号；慢性期T1WI表现为等或低信号,T2 WI以高信号或流空信号.3D-PC法MRV主要表现为脑静脉窦的闭塞或充盈缺损.同时14例患者合并有脑实质异常,出血9例,缺血水肿5例.结论 常规MR序列与3D-PC法MRV显示脑静脉窦血栓具特征性,可做为理想的检查手段.

Cerebral venous thrombosis diagnosed by magnetic resonance

Objective To evaluate the value of conventional magnetic resonance （MR） and 3-dimensional phase-cantrast magnetic resonance venography （3D-PC MRV） in diagnosing cerebral venous thrombosis （CVT）. Methods We had col- lected 34 CVT and definited by clinic, inchnding 15 cases, 19 females, aged from 1 to 71 years old, with a median age of 38 years. All of these underwent conventional MR and 3D-PC MRV examination. There were 7 cases in the acute stage （1 ~5 days）, 18 cases in the subacute stage （6~21 days）, and 9 cases in the chronic stage （〉21 days）. Results The most of acute CVT are iso or hypointense to gray matter on T1 WI and hypointense on T2 WI; the most of the subacute CVT are hyperintense on T1 WI, and hypointense or hyperintense on T2 WI; chronic CVT is iso- or hypointense on TI WI, and hy- perintense or flow voids signal on T2 WI. All thrombosed segments present filling defect on 3D-PC MRV. 14 of 34 patients exhibit parenchyma change, such as haemorrhage（9） and ischemia（5）. Conclusion Conventional MR and 3D-PC MRV are ideal technique due to characteristics on diagnosis of CVT.