脑静脉与静脉窦血栓形成的MRV与DSA对照研究

Case-control study of cerebral venous sinus thrombosis between MRV and DSA

目的探讨MRV对不同时期脑静脉与静脉窦血栓形成(CVST)的诊断价值。方法分析15例CVST患者,同期行MRV和DSA检查,将3D CE-MRV及2D TOF-MRV与DSA进行对比,探讨MRV对不同时期CVST的诊断价值。结果在急性及亚急性期CVST,3D CE-MRV的诊断准确性优于2D TOF-MRV。对于慢性期CVST,两者评价的灵敏度、特异度分别是:69.44%、98.15%和100%、89.47%;两者评价CVST治疗后再通的灵敏度、特异度分别是:81.82%、71.88%和60.00%、100%。结论对急性及亚急性CVST,3D CE-MRV较2D TOF-MRV的诊断准确性高。对慢性期及再通后的CVST,宜同时行3D CE-MRV和2D TOF-MRV检查,结合原始图像及MIP图像综合评价,必要时行DSA检查。

Objective The purpose of our study is to prospectively investigate the diagnostic value of MRV in the evaluation of different stages of CVST using DSA as the reference standard. Methods A total of 15 patients with CVST were recruited into this study. Diagnostic accuracy of MRV in the detection of different stages and recanalized of thrombus was evaluated. Results In the acute and subacute phase of CVST, the diagnostic accuracy of 3D CE- MRV was better than that of 2D TOF-MRV. The sensitivity and specificity of 3D CE-MRV and 2D TOF-MRV for chronic cvsr were 69.44%, 98.15% and 100%, 89.47% respectively; the sensitivity and specificity of3D CE-MRV and 2D TOF-MRV for the recanalized CVST were 81.82%, 71.88% and 60. 00%, 1130% respectively. Conclusion Compared with 2D TOF-MRV, 3D CE-MRV provides a high sensitivity and specificity for the diagnosis of acute and subactue CVST, which almost has the same diagnostic value as DSA. In the diagnosis of chronic CVST and recanalized CVST segments, beth 3D CE-MRV and 2D TOF-MRV are suggested to estimate pathogenetic condition with the reference of the original image with MIP images. DSA would be performed if necessary.