颅内静脉窦血栓形成9例临床与影像学分析

Clinical and imaging analysis of cerebral venous sinus thrombosis in 9 cases

目的探讨颅内静脉窦血栓形成(CVST)的临床与影像学特点。方法回顾性分析9例CVST患者的临床、影像学资料。结果9例患者的男女比例为1:1.25,平均发病年龄(46.7±14.9)岁;主要诱因为恶性肿瘤;临床主要表现为头痛、头晕、视物模糊、失语、肢体无力、癫痫发作等症状,可孤立或联合出现。仅有2例患者的头颅CT平扫显示病变静脉窦内高密度及条索征等直接征象。7例患者的头颅MR显示病变静脉窦内流空信号消失,随时相不同呈现不同信号影,增强扫描示"8"征。8例患者的头颅MRV均有不同程度的静脉窦病变,表现为受累静脉窦狭窄或闭塞。经低分子肝素抗凝、脱水降颅压等治疗后,全部患者临床症状基本消失。结论CVST临床表现复杂多样,缺乏特异性。头颅MR+MRV检查是诊断的主要手段,抗凝及脱水降颅压具有良好的治疗效果。

Objective To investigate the clinical and imaging characteristics of cerebral venous sinus thrombosis （ CVST） . Methods Retrospectively analyzed 9 cases of CVST patients’ clinical and imaging data. Results 9 patients’ male to female ratio was 1∶1. 25, the average age was （46. 7 ± 14. 9） years; the main causes was malignant tumors; the clinical manifestations were headache, dizziness, blurred vision, aphasia, limb weakness, seizures and other symptoms, which can be isolated or the combination of all symptoms. Only 2 cases of patients’ cranial CT scan showed the lesions of sinus high density and strip signs. 7 cases’ MR showed venous sinus’ flow void signal disappeared, different signal intensity revealed along with the different phase, enhanced scan showed “delta＆quot; sign. MRV of these 8 patients had different degree of venous sinus le-sions, showing venous sinus stenosis or occlusion. The low molecular heparin anticoagulation and lowering the intracranial pressure after treatment, all the patients’ clinical symptoms disappeared. Conclusion The clinical manifestation of CVST is complicated and lack of specificity. The head MR＋MRV examination is a major diagnostic method. Anticoagulation and low-ering the intracranial pressure has good curative effect.