外伤性颅内静脉窦血栓形成的MRI诊断

MRI diagnosis for traumatic intracranial venous sinus thrombosis

目的探讨磁共振成像(MRI)结合磁共振静脉成像(MRV)在外伤性颅脑静脉窦血栓形成中的诊断价值。方法回顾性分析28例经临床及影像学诊断为外伤性颅脑静脉窦血栓形成的 MRI与MRV资料。磁共振均行常规SE序列T1WI、T2WI以及液性衰减反转恢复序列(FLAIR)扫描,并全部行二维时间飞跃法静脉成像(2d-TOF MRV)检查。结果外伤性静脉窦血栓形成最常累及上矢状窦、下矢状窦、横窦,表现为受累静脉窦流空效应消失,为不同信号的血栓所阻断。MRV则表现为受累静脉窦管腔的狭窄、中断以及属支的迂曲扩张。结论 MRI结合MRV能无创性的同时显示外伤性颅脑静脉窦血栓形成与脑挫裂伤,为外伤性颅脑静脉窦血栓形成的首选检查方法。

Objective To assess the value of MRI and MR venography （MRV） in the diagnosis of traumatic intracranial venous sinus thrombosis. Methods The data of MRI and MRV using SE-T1WI, T2WI, FLAIR-T2WI and 2D-TOF MRV in 28 cases with traumatic intracranial venous sinus thrombosis diagnosed clinically and imageologically was retrospectively analyzed. Results The superior sagittal sinus,inferior sagittal sinus and transverse sinus were most frequently affected with traumatic intracranial venous sinus thrombosis. The flow void disappeared in the affected sinus, and different signals of thrombus were seen insteadly. MRV displayed the intracranial venous sinus thrombosis with direct signs including disapperance of the flow signal and stenosis in the affected sinus, and the indirect signs including circuity of the subordinate vein and the formation of the collateral circulation. Conclusion The combination of MRI and MRV is the first choice for the diagnosis of traumatic intracranial venous sinus thrombosis for its simultaneous display of thrombosis and brain trauma without invasiveness.