磁共振静脉血管成像在脑静脉窦血栓形成诊断中的应用

The application of MRV in diagnosis of cerebral venous sinus thrombosis

目的 评价 2D TOF法磁共振静脉血管成像 (MRV)在脑静脉窦血栓形成 (CVST)诊断中的价值。方法 对 10例CVST患者进行 2D TOP法MRV检查 ,并与MRI和数字减影血管造影 (DSA)结果进行对照研究。结果 10例患者均为多发性CVST ,最常累及上矢状窦和横窦。在MRV上CVST的直接征像为发育正常的静脉窦不显影、狭窄或再通后的模糊影 ,间接征像为病变以远侧枝血管形成、深部静脉明显扩张或其他引流静脉显现。本组MRV结果与DSA比较具有较高的一致性 ,且在血管变异的鉴别及对血栓的动态观察上要优于DSA。结论 MRV可替代DSA作为CVST诊断和随访的首选检查方法。

Objective To evaluate the value of magnetic resonance venography (MRV) in diagnosis of cerebral venous sinus thrombosis(CVST). Methods Ten patients with CVST were examined by 2D-TOF MRV. MRV images were analysed and compared with MRI and DSA images.Results In all patients MRV could display multiple CVST. The superior sagittal sinus and transverse sinus were most frequently affected. Direct signs of CVST on MRV included lack of typical high flow signal or stenosis from a sinus that did not appear aplastic or hypoplastic on single sections from MRV, and the frayed appearance of the flow signal from a recanalized sinus. Indirect signs of CVST included evidence of formation of collateral circulation, unusually prominent flow signal from deeper vein, or visualization of emissary vein. Comparing with DSA, MRV achieved a high degree of accuracy in our patients and was superior to DSA in the identification of nonpathologic variants of dural sinus and follow-up of CVST.Conclusion Primary use of MRV is recommended for the diagnosis and follow-up of CVST.