颅内静脉窦血栓形成的临床及影像学分析

Clinical and imaging analysis of cerebral venous sinus thrombosis

目的分析颅内静脉窦血栓形成(CVST)的临床及影像学特点,为临床诊断及治疗提供依据。方法选取2014年10月—2016年7月收治的46例CVST病人的临床及影像学资料进行回顾性分析。结果 CVST病人起病形式多样,临床表现多样,大多有头痛症状,其他症状有局灶性的神经功能障碍、意识障碍等。影像学方面,CT平扫12例(12/42)发现异常,MRI平扫(T1WI、T2WI、FLAIR)发现异常者32例,MRV检查显示异常者45例,46例病人通过MRI+MRV均能得到诊断,所有病例经过抗凝及对症支持治疗后均预后良好。结论颅内静脉窦血栓形成病因较多,临床症状复杂且缺乏特异性,结合CT、MRI及MRV可对其进行诊断,必要时可行DSA检查,早期抗凝治疗能有效改善预后。

Objective To provide the basis for clinical diagnosis and treatment by analyzing the clinical and imaging features of cere-bral venous sinus thrombosis. Methods Theclinical and imaging data of 46 cases with cerebral venous sinus thrombosis were retrospec-tively analyzed from October 2014 to July 2016. Results The patients in this group have a variety of onset andclinical manifestations, most with headache symptoms, also with other symptoms such as focal neurological dysfunction, disturbance of consciousness, etc. Ima-ging study,CT plain scan in 12 cases（12/42） found abnormalities. 32 cases of abnormalities were detected by MRI plain scan（TlWI, T2WI, FLAIR）. MRV examination showed abnormal in 45 cases. 46 patients can be diagnosed by MRI ＋ MRV, The patients in this group have good prognosisthroughanticoagulant therapy and symptomatic and supportive treatment. Conclusion The causes of CVST are sophisticated and the forms ware various, with no specific clinical manifestations. Combined with CT,MRI and MRV,even with DSA,CVST can be diagnosed. Early anticoagulation therapy can improve the prognosis effectively.