论文部分内容阅读
目的评价MRI对儿童脑静脉窦血栓(CVST)的临床诊断价值。方法回顾性分析15例(男11例,女4例,年龄10天～11岁,平均3.9岁)经临床确诊为CVST患儿的MRI及MRV表现。对所有病例均行MRI及MRV平扫,其中1例行增强MRI(CE-MRI)和增强MRV(CE-MRV)扫描。结果 14例横窦受累,12例上矢状窦受累,11例乙状窦受累,1例蝶顶窦受累。MR平扫6例表现为T1WI等高信号、T2WI高信号;3例表现为T1WI等高信号、T2WI低信号;3例表现为T1WI、T2WI等信号;1例T1WI高信号、T2WI等信号;2例T1WI和T2WI血栓显示不明显。增强扫描表现为脑静脉异常强化,静脉窦壁表现为环形、三角形或平行状强化,而静脉窦内血栓无强化,呈不规则充盈缺损或空三角征。MRV表现为受累静脉窦显影不规则、狭窄或中断、侧支血管形成,邻近深静脉及浅静脉迂曲扩张。结论 MRI结合MRV,特别是增强MRI和MRV是诊断儿童CVST的有效手段,对于临床及时诊断治疗及随访具有重要价值。
Objective To evaluate the value of MRI in the diagnosis of cerebral venous sinus thrombosis (CVST) in children. Methods The MRI and MRV findings of 15 patients (11 males, 4 females, aged 10 days to 11 years, mean age 3.9 years) were retrospectively analyzed. MRI and MRV were performed in all cases. One case underwent enhanced MRI (CE-MRI) and enhanced MRV (CE-MRV). Results 14 cases of transverse sinus involvement, 12 cases of superior sagittal sinus involvement, 11 cases of sigmoid sinus involvement, 1 case of maxillary sinus involvement. MR plain scan showed 6 cases of T1WI contour signal and T2WI high signal; 3 cases showed T1WI contour signal, T2WI low signal; 3 cases showed T1WI, T2WI and other signals; 1 case of T1WI high signal, T2WI and other signals; 2 T1WI and T2WI thrombus showed no obvious. Enhanced scan showed abnormal enhancement of the cerebral veins, sinus wall showed ring, triangle or parallel to strengthen, and no enhancement of sinus thrombosis, irregular filling defect or empty triangle sign. MRV manifested as irregular, stenosis or disruption of involved sinus, collateral vessel formation, tortuous dilation adjacent to deep veins and superficial veins. Conclusion MRI in combination with MRV, especially enhanced MRI and MRV, is an effective method to diagnose children with CVST, which is of great value for clinical diagnosis and follow-up.