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中华诊断学电子杂志 ›› 2019, Vol. 07 ›› Issue (01) : 11 -16. doi: 10.3877/cma.j.issn.2095-655X.2019.01.003

所属专题: 文献

影像学诊断研究

脑静脉窦血栓形成的影像学特征分析
谢光彤1, 丁长青1,(), 王雪璐1, 白麟鹏1   
  1. 1. 221700 江苏省丰县人民医院影像科
  • 收稿日期:2018-10-09 出版日期:2019-02-26
  • 通信作者: 丁长青
  • 基金资助:
    江苏省卫生厅医学科研立项课题(YG201419); 徐州市第一期医学青年后备人才培养工程资助项目(徐卫科教2014年3号)

Imaging feature analysis of cerebral venous sinus thrombosis

Guangtong Xie1, Changqing Ding1,(), Xuelu Wang1, Linpeng Bai1   

  1. 1. Department of Imaging, Fengxian People′s Hospital, Fengxian 221700, China
  • Received:2018-10-09 Published:2019-02-26
  • Corresponding author: Changqing Ding
  • About author:
    Corresponding author: Ding Changqing, Email:
引用本文:

谢光彤, 丁长青, 王雪璐, 白麟鹏. 脑静脉窦血栓形成的影像学特征分析[J/OL]. 中华诊断学电子杂志, 2019, 07(01): 11-16.

Guangtong Xie, Changqing Ding, Xuelu Wang, Linpeng Bai. Imaging feature analysis of cerebral venous sinus thrombosis[J/OL]. Chinese Journal of Diagnostics(Electronic Edition), 2019, 07(01): 11-16.

目的

探讨脑静脉窦血栓(CVST)形成的电子计算机断层扫描(CT)及磁共振成像(MRI)表现特征。

方法

回顾性分析2014年11月至2018年3月,江苏省丰县人民医院神经内科收治的14例CVST患者的临床及影像学资料。所有患者均行CT及MRI平扫,3例行MRI增强扫描,5例行磁共振静脉血管成像(MRV),2例行磁共振动脉血管成像(MRA)。观察CVST累及区域范围及周围情况、平扫密度或信号特征及颅内伴发病变等。

结果

全部患者均累及2个以上静脉窦,7例患者CT平扫见受累静脉窦明显高密度,MR平扫10例患者可见受累静脉窦T1WI明显高信号或混杂信号,T2WI及FLAIR均可见受累静脉窦高信号。3例行MRI增强扫描患者中,受累及静脉窦呈完全强化2例,部分性强化1例。CT及MRI提示左颞叶出血性梗死1例,矢状窦旁占位2例,丘脑出血性梗死1例,皮层蛛网膜下腔出血2例。MRV均可见受累静脉窦显影不规则、狭窄或完全不显影及侧支代偿血管形成。

结论

MRI平扫可显示CVST的特征,CT平扫部分患者显示CVST的特征,CT及MRI平扫均可显示CVST的颅内伴发病变。识别CVST的静脉窦CT及MRI平扫特征及可能的颅内继发病变影像学表现,并结合MRV检查有助于准确诊断。

Objective

To explore the CT and MRI features of cerebral venous sinus thrombosis (CVST).

Methods

From November 2014 to March 2018, the clinical and imaging data of 14 patients with CVST diagnosed by clinical follow-up in the Department of Neurology of Fengxian People′s Hospital were retrospectively analyzed. All patients underwent plain CT and plain MR scan, 3 patients also underwent MRI enhancement scans, 5 patients had MRV and 2 patients had MRA examination data. The involvement area and surrounding conditions, plain scan density or signal characteristics and intracranial associated changes of the CVST were observed.

Results

All cases involved more than 2 sinusoids. Plain MRI revealed a hyperintense signal on T2WI and FLAIR in the affected sinuses in all patients, 7 patients were found with high density in the affected sinuses in the plain CT scan, and a hyperintense signal or mixed signal on the T1WI in the involved sinuses in 10 cases. The features of the three enhanced MRI cases were partial enhancement (n=1) and complete enhancement (n=2). CT and MRI revealed 1 case of hemorrhagic in left temporal lobe 2 cases of space-occupying lesions parasagittal meningiomas, 1 case of hemorrhagic infarction in thalamic and 2 cases of cortical subarachnoid hemorrhage. MRV showed that the involved venous sinuses were irregularly developed, stenosis or completely undeveloped, and collateral compensatory vascularization.

Conclusions

CVST can be displayed by MRI and be partially displayed by CT, and its possible intracranial lesions can be displayed by CT or MRI. Recognizing the characteristics of CVST in the responsible venous sinus and its possible intracranial lesions on plain CT and plain MRI and combining with MRV examination are helpful for accurate diagnosis.

图1 左侧侧窦血栓形成伴左颞出血性梗死患者影像学检查图像
图2 脑膜瘤患者肿瘤压迫所致矢状窦血栓形成影像学图像
图3 Galen静脉直窦血栓形成伴右侧丘脑出血性梗死患者影像学图像
图4 上矢状窦血栓形成伴皮质蛛网膜下腔出血患者影像学图像
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