脑静脉(窦)血栓的临床特征和磁共振特点

Clinical features and MR imaging characteristics of cerebral venous thrombosis

目的 探讨脑静脉 (窦 )血栓 (CVT)的临床特征和磁共振 (MR)特点。方法 回顾分析 1 2例经MR检查确诊的CVT患者的临床表现和影响学特征。结果 1 2例患者的阳性体征包括头痛 (1 0例 )、视乳头水肿 (8例 )等颅内压增高的征象 ,部分病例有局灶性神经功能异常如肢体瘫痪 (4例 )、外展神经麻痹 (2例 )、癫痫发作 (2例 )、昏迷 (2例 )及脑膜刺激征 (6例 )。常规Se序列T1 、T2 相示窦内高信号 ,脑实质水肿或合并出血、梗死。磁共振静脉血管成像 (MRV)能直接显示静脉窦闭塞及血栓栓子。CT检查显示 2例呈弥漫性脑水肿 ,3例脑叶见条索状高密度影 ,2例示顶叶出血 ,1例蛛网膜下腔出血。经降颅压、抗凝、溶栓、消炎及激素治疗均治愈。结论 MRI/MRV在诊断和随诊静脉窦血栓方面明显优于CT ,且抗凝、溶栓、降颅压、消炎是治疗静脉窦血栓的有效方法之一。

Objective To investigate the clinical features and MR imaging characteristics of cerebral venous thrombosis.Methods 12 cases cerebral venous thrombosis proved by MR were reviewed retrospectively in clinic and with MR imaging.Results The positive symptoms among the 12 cases were headache (10 cases),palilledema (8 cases),which indicated intracranial hypertension,some cases had focal neurological dysfunction such as limb palsies (4 cases),abducent paralysis (2 cases),seisures (2 cases),Coma(2 cases) and meningeal irritation (6 cases).The MRI with routine Se sequence T 1,T 2 reaveled the abnormal signals inside the thrombosed sinuses,cerebral edema,hemorrhage or infarction.MRA could find the occluded sinus and the clot directly.The CT scanning found the signs of diffuse cerebral edema (2 cases),high density streak image in cerebral lobe (3 cases),parietal hemorrhage (2 cases) and subarachnoid hemorrhage (1 case).All the patients recouered well with the treatment of dehydrant,anticoagulant,thrombolysis,anti infection and adreno cortical hormone.Conclusions MRI/MRV is more powerful than CT scanning in the diagnosis and investigation of CVT;Anticoagulation,thrombolysis,dehydrantion,and antifection may be effective treatment of cerebral venous thrombosis.