脑静脉窦和深静脉血栓形成的CT和MRI诊断

CT and MRI for Diagnosis of Cerebral Venous Thrombosis

探讨脑静脉窦和深静脉血栓形成的CT与MRI表现特点。回顾性分析22例脑静脉窦和深静脉血栓患者的头颅CT、MRI影像学表现。受累静脉窦或静脉系统:上矢状窦血栓18例,右侧横窦14例,左侧横窦13例,右侧乙状窦10例,左侧乙状窦6例,直窦血栓5例,2例合并大脑内静脉血栓形成。14次CT平扫,9次出现直接征象(急性期3次,亚急性期6次);22次MRI平扫,12次出现流空信号消失,表现为高信号三角征(急性期5次,亚急性期6次,慢性期1次),5次增强MRI显示空三角征,21次MRV显示受累的静脉窦或静脉不显影。CT与MRI(MRV)检查是诊断静脉血栓形成可靠的手段。对急性静脉血栓形成者,CT是一种简单有效的诊断方法;对于亚急性期、慢性期CVT者,MRI、MRV检查具有优势。

To discuss the CT and MRI features of Cerebral venous thrombosis. The finding of CT, MRI and magnetic resonance venography （MRV） in 22 patients with CVT were retrospectively analyzed. The thrombosis of superior sagittal sinus, right transverse sinus, left transverse sinus , right sigmoid sinus , left sigmoid sinus, and straight sinus was seen in 18 cases, 14 cases, 13cases, 10 cases, 6cases and 5 cases respectively, internal cerebral veins were also involved in 2 cases. All patients , who were received CT examination for14 times, in the acute phase, showed the direct CVST signs for 3 times, but 6 times in subactue phase, MRI, that were performed for 22 times, showed the disappearance normal flow void in the dural sinus or veins for 12 times, the abnormal high signal intensities were showed for 5 times in acute stage, and 6 times in subactue stage and 1 time in chronic stage, and “δsign” were found in MRI with contrast enhancement for 5 times. MRV demonstrated that there was no blood flow in these involved dural sinuses or veins for 21 times. CT is a simple and effective method to diagnose acute CVT. Conventional MRI combined with MRV are effective and noninvasive methods in the diagnosis of subacute and chronic CVT.