3.0T磁共振对静脉性脑梗死的评估

Assessment of venous infarction by 3.0T MR

目的回顾性分析静脉性脑梗死的磁共振(MR)表现,提高诊断水平。方法对7例静脉性梗死患者影像资料进行回顾性分析,7例均行常规MR、DWI、SWI及MRV扫描。结果 7例脑内多发病灶5例,单发病灶2例,7例中发生于额叶2例,颞叶1例,顶叶3例,丘脑1例;病变T1WI呈等或低信号,T2WI呈高信号,边缘模糊,伴脑肿胀,少量水肿,并出血时,出现出血信号,DWI呈略高信号;SWI示小出血灶为低信号,Min IP-SWI可显示病灶周围增多、扩张的小静脉。静脉栓塞部位:4例为上矢状窦,4例为横窦,2例为直窦,4例为乙状窦,2例为大脑内静脉及大脑大静脉,窦汇2例,受累静脉窦均为多个,1例未见静脉窦受累。7例均行3DCE-MRV扫描,发现栓塞部位表现为低信号充盈缺损。结论静脉性脑梗死MR表现有特异性,常规MR结合MRV可作为首选的检查方法,对静脉性脑梗死早期诊断早期治疗有着重要作用。

[ Objective ] To study the MR features of venous infarction, in order to improve the diagnosis accuracy. [Methods] The MR images of 7 cases of venous infarction were analyzed retrospectively. All the 7 patients were performed conventional MR, DWI, SWI and MRV scanning. [Results] In 7 cases, there were 5 cases with multiple cerebral lesions, 2 cases with single lesion. The lesions were located in the frontal lobe in 2 cases, temporal lobe in 1 case, parietal lobe in 3 cases, and thalamus in 1 case. The lesion showed equal or low signal intensity on T1WI, high signal intensity on T2WI, fuzzy edge, with brain-swelling, edema, and bleeding signal after hemorrhage, slightly higher signal on DWI; small bleeding lesions showed low signal on SWI, MinIP-SWI displayed that the small vein around the leision increased and expanded. The location of venous thrombosis were as follows： 4 cases superior sagittal sinus, 4 cases transverse sinus, 2 cases straight sinus, 4 cases sigmoid sinus, 2 cases internal cerebral vein and vein of Galen, 2 cases confluence of sinuses, multiple involved venous sinus, 1 case non-involved venous sinus. Seven cases underwent 3DCE-MRV scanning, and low signal filling defect in embolism-position was found. [ Con- clusions] The appearance of venous infarction is specific, conventional MR combined with MRV can be used as the preferred method, which has played an important role in early diagnosis and early treatment of venous infarction.