上矢状窦血栓形成早期大脑灰质CT特殊表现(附1例报道及文献复习)

目的分析上矢状窦血栓形成的早期大脑灰质CT特点,提高对上矢状窦血栓形成早期大脑灰质CT特点的认识。方法结合文献对1例上矢状窦血栓形成患者的早期脑CT影像学特点进行分析。结果患者发病后6h行脑CT平扫显示双侧额叶皮质高密度影;第3d时脑MRIT1显示上矢状窦前部血栓形成可疑,脑FLAIR-MRI显示右侧额叶高信号及左侧额叶弧形高信号,脑MRIT1相增强扫描显示双侧额叶皮层弧线型增强,MRV显示上矢状窦前1/3处见一无信号区,周围有侧枝循环形成;治疗第6d时复查脑CT和MRI均无出血征象。结论患者早期脑CT所显示的高密度影可能是皮层静脉和毛细血管血液淤积的显示,并不全是出血,对于该征象的认识并结合病理生理过程给予的合理解释对于及时正确的认识该病具有重要意义。

CT finding of gray mather in the early stage in superior sagittal sinus thrombosis (a case report and literature review)

Objective To study CT features of gray mater in patients with superior sagittal sinus thrombosis,and to improve the recognition about it.Methods One case of superior sagittal sinus thrombosis was diagnosed,and the CT features were analyzed with the review.Results In the initial brain CT scan(6 hours after onset),bilateral frontal cortices showed focal lesions of high density.3 days after onset,fluid-attenuated inversion recovery image MRI showed a hyperintense lesion in the right frontal lobe and curvilinear hyperintense structures in the left frontal gray matter.Postcontrast T1-weighted image showed bilateral curvilinear enhancement in the frontal gray matter.MRV showed signal loss in the anterior part of superior sagittal sinus.Both CT and MRI displayed normal change on the 6 th day after onset.Conclusions The lesions of increased densities in the cortices may represent blood congestion in the cortical veins and capillaries,and not haemorrhage.The signs should be recognized and be interpreted carefully based on pathophysiologic features and it is important to make perfect diagnosis and management.