不同MRI成像序列在急性脑静脉窦血栓形成及其脑损害诊断中的价值

Clinical Significance of Different MRI Sequence Detections in the Diagnosis of Acute Cerebral Venous Sinus Thrombosis and Cerebral Injury

目的探讨急性脑静脉窦血栓形成与脑损害诊断采用MRI不同成像序列检测的临床价值。方法方便选取2014年6月—2015年6月期间该院15例急性脑静脉窦血栓患者,均经临床影像学检查确诊,回顾性分析患者的临床影像学资料,对比分析不同MRI成像序列与MRV检测急性脑静脉窦闭塞及其继发脑损伤的优劣势,并测量脑损害区的ADC值。结果该次研究中,有上矢状窦血栓者15例,11例合并横窦血栓,乙状窦血栓7例,下矢状窦血栓6例,直窦血栓10例;继发性脑损伤12例,其中8例脑出血性梗死,3例无脑损伤,4例单纯缺血性梗死;T2TSE对缺血水肿的检测优于其它序列,而对脑出血的检测则以T2TIRM较好;缺血坏死边缘区低于中央区的ADC值,病灶面积较小者的中央区较面积较大的病灶ADC值要低,差异有统计学意义(P<0.05)。结论急性脑静脉窦血栓形成及脑损害采用MRI诊断,提高了临床诊断的准确率,为临床医师的明确诊断、治疗方案提供了有效的参考依据。

Objective To study the clinical significance of different MRI sequence detections in the diagnosis of acute cere-bral venous sinus thrombosis （CVST） and cerebral injury. Methods Convenient selection the clinical imaging data about 15 patients with acute CVST in our hospital was retrospectively analyzed; the advantages and disadvantages of different MRI sequences and MRV on the diagnosis of acute cerebral venous sinus occlusion and secondary cerebral injury were analyzed;the value of ADC on the cerebral injury areas was estimated. Results In this study, 15 cases of superior sagittal sinus thrombosis and 11 patients with thrombosis of transverse sinus and sigmoid sinus thrombosis in 7 cases, inferior sagittal si-nus thrombosis in 6 cases, straight sinus thrombosis in 10 cases; secondary brain injury in 12 cases, including 8 cases of cerebral hemorrhage infarction, 3 cases without brain injury, 4 cases with pure ischemic infarction ; T2WI had a higher ac-curacy on the ischemic edema; T23WI had a higher accuracy on the cerebral hemorrhage. Ischemic necrosis of the central ADC region is lower than the edge value,Focus area of the smaller central area is larger the ADC value was lower,P〈0.05. Conclusion MRI is of great importance in the diagnosis of acute CVST and cerebral injury.