MRI联合MRV诊断17例脑静脉窦血栓形成的价值分析

The value analysis of MRI combined with MRV diagnosis in 17 cases with cerebral venous sinus thrombosis

目的对脑静脉窦血栓形成（CVST）患者的磁共振成像（MRI）和磁共振静脉成像（MRV）影像学表现进行分析，为临床诊疗提供参考依据。方法回顾性分析17例经数字减影血管造影（DSA）确诊CVST患者的影像学资料，全部行MRI平扫，其中行MRI平扫增强扫描检查8例，行MRV检查9例，行DSAS检查5例。结果17例CVST患者中1例单纯乙状窦受累，1例单纯直窦受累，2例单纯横窦受累，4例单纯上矢状窦受累，4例上矢状窦和横窦同时受累，5例乙状窦和上矢状窦同时受累。MRI平扫见脑静脉窦流空效应消失，其中2例CVST患者T，WI等信号，且T2WI低信号；12例CVST患者T1WI和T2WI均为高信号；3例CVST患者T，WI低信号不均匀，且T2WI高信号。行MRI平扫增强扫描检查8例，表现为脑静脉异常强化，静脉窦表现为不同形状的强化，窦内血栓无强化，表现为缺损或空状。DSA和MRV检查显示受累静脉窦表现为不规则的显影，狭窄影或不显影。结论MRI联合MRV不仅可以通过直接征象和间接征象提高CVST的诊断率，而且还可以反映病理演变和评价疗效，是早期诊断CVST和动态观察治疗疗效的理想手段。

Objective To analyze MRI and MRV imaging of cerebral venous sinus thrombosis （CVST） formation, to provide a reference for the clinical diagnosis and treatment. Methods Seventeen cases of CVST patients confirmed by digital subtraction angiography （ DSA）, all underwent MRI plain scan, which MRI plain scan CT enhancement scanning 8 cases, MRV check 9 cases, DSAS check 5 cases. Results Seventeen cases of patients with CVST,one case of simple sigmoid sinus involvement, one case of simple straight sinus involvement, two cases of purely transverse sinus involvement, four cases of simple sagittal sinus involvement, four cases of superior sagittal sinus and transverse sinus were simulta- neously involved, five cases of sigmoid sinus and superior sagittal sinus involvement MRI. plain scan show the effect of cerebral venous sinus flow void disappeared, including 2 cases of CVST patients showed T1 WI signal, T2WI low signal; 12 cases of patients with CVST showed T1WI and T2WI high signal; uneven three cases of CVST patients with low intensity on T1 WI and T2WI high signal, eight cases underwent MRI scan CT enhancement scanning, showed abnormal enhancement of cerebral venous, showed venous sinus strengthening of the different shapes, sinus thrombosis without strengthening, showed defect or empty like. The DSA and MRV checking showed the affected sinus, developing irregular, narrow shadow or not developing. Conclusions MRI combined with MRV not only can improve diagnosis rate of CVST by direct signs and indirect signs, but also reflects the pathological evolution and efficacy value, is the ideal means of early diagnosis of CVST and dynamic observation treatment efficacy.