磁敏感加权成像及T_2*梯度回波序列在颅内静脉血栓形成中的应用

Application of susceptibility weighted imaging and T_2* susceptibility weighted imaging in cerebral venous thrombosis

目的分析大脑静脉系统血栓形成(cerebral venous thrombosis,CVT)的临床及影像学特点,主要是磁敏感加权成像及T_2*梯度回波序列。方法收集我院11例大脑静脉系统血栓形成病例(6例皮质静脉血栓,4例静脉窦血栓,1例皮质静脉合并静脉窦血栓),分析其病因及影像学特点。结果 11例CVT女3例,男8例,平均年龄(40±21)岁。头部CT及MRI示不同脑叶出血性梗死、窦汇高密度、横窦束带征、静脉窦高信号等。MRV和全脑血管造影术(digital subtraction angiography,DSA)示静脉窦血栓形成,皮质静脉血栓或横窦乙状窦先天发育不良。头部MRI的SWI和T_2*序列示静脉窦血栓或皮质静脉区血栓,2例未发现异常。6例SWI和T_2*序列显示静脉血栓一致。2例SWI和T_2*序列阴性病例通过MRV或DSA诊断。结论 CVT是颅内静脉系统的血栓栓塞性疾病,多见于中青年,头部MRI的SWI像和T_2*序列对于皮质静脉血栓诊断非常重要,对于静脉窦血栓形成病例有很大帮助。T_2*和SWI序列可作为颅内静脉血栓形成的常规检查。

Objective To analyze clinical,susceptibility weighted imaging（ SWI） and T_2＊susceptibility weighted imaging（ T_2＊WI） features of cerebral venous thrombosis（ CVT）. Methods We reported 11 cases of CVT admitted in our hospital（ 6 cases were isolated Co VT,4 cases were cerebral sinus venous thrombosis and 1 cases were was Co VT with cerebral sinus venous thrombosis）. We reviewed and summarized the clinical manifestation,radiological feature. Results 3 cases were female and 8 cases were male. The average age was（ 40 ± 21） years old. Brain CT scan and MRI showed hemorrhagic cerebral infarction in different lobes focus,sinuses high density,sinus transverses cord sign or sinus venosus high signal in T1 scan. MRV and DSA showed sinus thrombosis or dysplasia of sinus transverses or sigmoid sinus. SWI and T_2＊WI showed sinus thrombosis or cortical vein thrombosis,2 cases were negative. 6 cases in SWI and T_2＊WI had the same results. 2 cases with no focus in SWI and T_2＊WI were diagnosed through MRV or DSA. Conclusion CVT is cerebral venous thrombosis disease. Most cases of CVT were younger or middle-aged. SWI and T_2＊WI were very important in cortical vein thrombosis. SWI and T_2＊WI were very helpful in sinus venosus thrombosis. SWI and T_2＊WI could be the regular examinations for CVT.