静脉性脑梗死MR影像特点

MR imaging features of venous cerebral infarction

目的回顾总结静脉性脑梗死MRI及MRV影像表现,旨在提高影像诊断水平。方法对15例静脉性脑梗死的MR表现进行了回顾性分析,其中9例临床治疗后复查MR表现明显好转,临床症状明显改善。15例均行常规MRI平扫,其中9例同时进行MR增强及3DCE-MRV,6例行2DTOF MRV。结果 15例脑内多发病灶9例,单发病灶6例,其中2例脑梗死伴出血改变。15例中发生于额叶4例,顶叶6例,颞叶3例,枕叶1例,小脑1例。静脉栓塞部位11例为上矢状窦,1例直窦及左横窦,1例右侧横窦及乙状窦,2例皮层大脑浅静脉。9例行增强扫描,5例病灶内不规则强化,2例脑膜强化,3例无强化.7例MRV均显示栓塞的静脉血流信号丢失或缺损,3例出现异常静脉侧支或引流静脉异常扩张。结论静脉性脑梗死MR影像表现具有特征性,MRI结合MRV可以作为首选的无创检查方法,对静脉栓塞早期诊断和治疗有重要作用。

Objective This article aims at the evaluation MR imaging findings of venous cerebralin farctionand for the purpose of improving the diagnostic accuracy. Methods We retrospectively reviewed the MR features of venous cerebral infarction in 15 cases, 9 of them had been proven effective by MR and clinical therapy, 6 of them had 2D MR venography examination, and 9 cases underwent both 3D CE MRA and enhanced MR scan. All 15 cases underwent MR conventional examination. Results All 15 cases, multiple cerebrain volved were found in 9 cases and unilateral in 6 cases. There were 2 cases cerebralin infarction with hemorrhage. Venous cerebral infarction located in lobus frontalis in 4 cases, lobus parietalis in 6, lobus temporalis in 3, lobus occipitalis in 1 and cerebella in 1. Blocked dural sinuses and veins were included superior sagittal sinus in 11 cases, straight sinus and left transverse sinus in 1 case, double transverse sinus and sigmoid sinus in 1 case, pallium superficial vein in 2 cases. In 9 cases which underwent enhanced scan, the lesion appeared irregular enhancement in 5 cases, and cerebral dura mater enhancement in 2 cases, the lesion were not enhanced in 3 cases. MRV images showed lack of flow signal from the blocked venous channels in 7 cases and formation of collaterials or visualization of emissary veins in 3 cases. Conclusion Venous cerebralin infarction have characteristic MR images that is important for early diagnosis and therapy of venous embolism. MRI combined MRV is a primary noninvasive examination method.