脑内静脉窦血栓形成MRI表现的再探讨和MR静脉成像的选择

MRI Findings of Intracerebral Venous Sinus Thrombosis and the Choice of MR Venography

目的:明确脑内静脉血栓形成的脑内MRI表现和MR血管造影的诊断及检查方法。材料和方法:共9例病人,男性2例,女性7例。年龄30-56岁,平均 38.2岁。使用 Siemens vision-plus超导高场 MRI系统,场强1.5T。采用常规SE序列,tuber SE,TOF血管成像（用于动脉血管显示）,PC法2D静脉血管成像和增强3D静脉血管成像（用于矢状窦显示）。结果:MR的动脉血管成像显示阳性率为0％,2D和3D静脉血管成像阳性率为100％,3D增强静脉血管造影可更好地显示阻塞的静脉。脑实质内均有阳性表现,表现为矢状窦旁白质区对称或非对称性异常改变,呈斑片状和片状,T1W为低信号,T2W为高信号。增强后脑膜强化2例。合并脑内出血5例。结论:MRI结合MR静脉血管造影,尤其增强3D静脉血管造影是诊断脑内静脉血栓形成的有效手段。

Purpose: To define the intracerebral MRI findings in intracerebral venous sinus thrombosis and the methods of MR venography. Materials and Methods: Nine patients were studied with Siemens vision -plus high - field(1.5) MRI system(men 2 women 7 age 30 - 56 years average age 38.2 years) . The usual SE series(tuber SE) and TOP angiography were used to show arteries.PC 2D venography and 3D contrast venography were used to show the sagitall sinus. Results: None of the lesions were shown in the MR angiography. While 100% of the lesions were shown in the 2D and 3D MR venography. And 3D MR contrast venography revealed the obstructed vein more clearly. All patients had positive intracranial findings in MRI scans. MRI scans showed plate - like symmetric or asymmetric lesions surrounding the sagittal sinus, which showed hypotension in T1 and hypertension in T2.Five patients were complicated with intracerebral hemorrhage.Conclusion: MRI combined with MR venography, especially 3D contrast venography , are effective methods in the diagnosis of intracerebral venous thrombosis.