24例静脉性脑梗死MRI分析

MRI analysis on 24 cases of venous cerebral infarction

目的:分析MRI平扫、DWI及增强图像在静脉性脑梗死中的价值。方法:回顾性分析24例临床及病理证实的静脉窦血栓所致静脉性脑梗死患者临床症状及MRI表现。结果:24例患者发病时间(11±9)天。7例患者表现为孤立性颅高压。12例患者表现为出血性梗死。15例病灶梗死位于皮层、皮层下,仅1例累及深部白质。16例患者行DWI检查,梗死区面积明显小于T2 FLAIR序列,14例梗死灶ADC值增高。24例病灶增强扫描11例可见皮层静脉扩张,10例可见侧脑室旁或小脑半球放射状分布髓静脉扩张,10例可见脑膜强化。结论:MRI平扫、DWI及增强扫描在静脉性脑梗死中具有一定特征,对于皮层、皮层下多发出血及梗死,双侧基底节区及丘脑梗死,血管源性为主的梗死,都应考虑到静脉性脑梗死可能。

Objective:To analyze the values of DWI,conventional and enhanced MRI imaging in venous infarctions.Methods:Clinical symptoms and MRI images of 24 patients with infarctions caused by venous sinus thrombosis confirmed by clinical and pathologic evaluations were analyzed retrospectively.Results:The average time since onset of symptoms was(11±9)days.Seven patients presented with isolated intracranial hypertension.Twelve patients had hemorrhagic infarctions.Fifteen infarctions were located in the cortex and subcortical structures and one infarction was located in the deep white matter.Sixteen patients underwent DWI imaging,in whom the infarction size was smaller than the T2 FLAIR image.The ADC values increased in 14 patients.In 24 patients,eleven patients had cortical vein dilatation,10 had subependymal and deeper medullary vein dilation radially,and 10 had meningeal enhancement.Conclusions:Venous infarctions have distinct characteristics on DWI,conventional and enhanced MRI imaging.For hemorrhage and hemorrhagic infarctions multiple and located in the cerebral cortical and subcortical structures,bilateral basal ganglia and thalamic infarctions,infarctions with vasogenic edema,venous infarctions should be considered.