颅内静脉系统血栓形成临床与影像学特点分析

The Analysis of Clinical and Imaging Characteristics of Intracranial Venous Thrombosis

目的分析颅内静脉系统血栓形成患者的临床特点及影像学表现,以提高诊断和治疗效果。方法回顾性分析21例颅内静脉系统血栓形成患者的临床表现、影像学资料。结果 21例患者的男女比例为1∶1.6,平均发病年龄为(47±15)岁。16例(76.2%)为亚急性和慢性起病,MRI及CT检查表现为脑实质损伤10例(47.6%),其中7例(70%)为静脉性梗死。21例均存在横窦血栓,其中13例为左侧横窦(61.9%)。8例患者行DSA检查,均表现为静脉窦充盈缺损、血流中断,或引流静脉末端缺失。治疗18例中,14例病情好转,4例病情无好转甚至恶化。结论认识颅内静脉系统血栓形成的临床和影像学特征并尽早使用MRV进行筛查,能提高诊断和治疗效果。

Objective To analyze the clinical and imaging characteristics of patients with intracranial venous thrombosis in order to improve diagnosis and treatment effect. Methods Clinical manifestations and imaging data of 21 patients with intracranial venous thrombosis were analyzed retrospectively. Results The male to female ratio of 21 patients was 1 ： 1.6 and the average age of onset was （47±15） years old. Of the 21 cases, 16 cases were subacute or chronic （76. 2% ）, 10 cases （47.6%） were with cerebral parenchymal injury （47. 6% ） by MRI and CT examination and of which 7 （70%） were venous infarction. Transverse sinus thrombosis was found in all the 21 cases, in which left transverse sinus thrombosis occurred in 13 cases （61.9%）. DSA was performed in 8 cases, all of which showed filling defect in venous sinus, interruption of blood flow or terminal portion missing of drain veins. Of the 18 cases underwent treatment, 14 cases were improved after treatment, and 4 cases had no improvement or even worse. Conclusion Recognizing the clinical and imaging characteristics of intracranial venous thrombosis and screening with MRV as early as possible can improve diagnosis rate and treatment effect.