MRI及磁共振静脉血管成像诊断脑静脉窦血栓形成

MRI and MR venography in diagnosis of cerebral venous sinus thrombosis

目的评价MRI及磁共振静脉血管成像(MRV)对脑静脉窦血栓形成的诊断价值。方法回顾性分析11例经临床确诊脑静脉窦血栓形成患者的MRI表现。对所有病例均行MR平扫,其中5例行增强扫描,6例行MRV检查,2例行DSA检查。结果 4例上矢状窦及横窦同时受累,1例上矢状窦、横窦及乙状窦同时受累,4例单纯乙状窦受累,2例单纯横窦受累。MR平扫1例表现为T1WI等信号、T2WI低信号,8例表现为T1WI、T2WI高信号,2例表现为T1WI不均匀低信号、T2WI高信号;增强扫描5例表现为脑静脉异常强化,静脉窦壁表现为环形、三角形或平行状强化,而静脉窦内血栓无强化呈不规则充盈缺损或空三角征。MRV表现为受累静脉窦显影不规则、狭窄或不显影、侧支血管形成、邻近深部脑静脉扩张。结论 MRI结合MRV是诊断脑静脉窦血栓形成的无创、有效手段。

Objective To observe the value of MRI and magnetic resonance venography（MRV） in diagnosis of cerebral venous sinus thrombosis（CVST）.Methods MRI findings of 11 patients with clinically diagnosed CVST were analyzed retrospectively.All 11 patients underwent MR plain scan.Dynamic contrast enhanced scan was performed in 5 patients,while MRV was performed in 6 and digital subtraction angiography（DSA） in 2 patients.Results The thrombosis of superior sagittal sinus and transverse sinus was observed in 4 patients,superior sagittal sinus,transverse sinus and sigmoid sinus involvement in 1,while single sigmoid sinus involvement in 4 and single transverse sinus involvement in 2 patients.CVST manifested as isointense signal on T1WI and low signal on T2WI in 1,high signal on T1WI and T2WI in 8,and inhomogeneous low signal on T1WI and high signal on T2WI in 2 patients.Abnormal venous enhancement was found on contrast enhanced MRI in 5 patients.Contrast enhancement MRI showed ring-like,triangle and parallel enhancement in wall of venous sinus,but venous sinus thrombosis did not enhanced,but showed as irregular filling defect or empty triangle.Conclusion Conventional MRI combined with MRV are effective and noninvasive methods in the diagnosis of cerebral venous sinus thrombosis.