脑静脉窦及深静脉血栓的CT、MRI诊断

Diagnosis of cerebral venous sinus thrombosis and galen venous thrombosis with CT and MRI

目的:探讨脑静脉窦及深静脉血栓的CT和MRI表现及诊断价值。方法:回顾性分析17例脑静脉窦及深静脉血栓患者的CT和MRI表现特点。结果:CT表现为静脉窦密度略高信号增高、窦腔增宽(n=5/12),增强扫描可见“空三角”征(n=3/3);随着病程的改变,MRI可表现为静脉窦T1WI(n=15/17),T2WI(n=13/17)流空效应消失,磁共振静脉成像(MRV)及增强MRV可显示静脉窦闭塞及静脉窦内充盈缺损(n=17/17;n=4/4);CT及MRI还可见皮层及皮层下多发、散在的出血性脑梗塞(n=7/12;n=13/17),基底节区脑梗塞(n=3/12;n=4/17)等间接征象。结论:CT增强可以显示静脉窦血栓,MRI、MRV及增强MRV相结合能准确地诊断脑静脉窦及深静脉血栓,MRI优于CT平扫。

Objective： To analyze the CT and MRI features and diagnoses of cerebral venous sinus thrombosis （CVST）. Methods： 17 cases with CVST of CT and MRI manifestations were retrospectively analyzed.Results：Dilated and hyperdensie venous sinus were observed on CT scans （n = 5/12）, ＂δ sign＂ were seen on enhancement （n = 3/3） ; CVST presented high signal intensity on T1WI （n = 15/17）, normal flow empty effect disappeared （n= 13/17） and occlusion and filling defects were showed on magnetic resonance venography and magnetic resonance venography with contrast enhancement （n = 17/17; n = 4/4）. Cortical and subcortical hemorrhagic infarction were dispersed （n = 7/12; n = 13/17）, and infarction in basal nuclei were also found （n = 3/12; n = 4/17）. Conclusion： CVST may be found on CT enhancement, MRI,MRV and CE-MRV can precisely diagnose CVST. MRI is superior to CT in the diagnosis.