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目的探讨脑静脉窦血栓形成的影像学表现,进一步提高对本病的认识。方法回顾性地分析36例脑静脉窦血栓形成的影像学(包括MR I,CT和DSA)资料,男15例,女21例,年龄23~59岁。结果MR上T1加权像及T2加权像脑实质内出现异常信号26例,其中散在脑实质内出血并长T1长T2异常信号者16例,长T1长T2信号者6例,4例可见脑室扩大,4例脑肿胀,显示脑沟、池变窄。25例脑静脉窦不强化,但可见皮层静脉异常强化。CT上见脑肿胀并出血者10例,伴脑缺血性低密度者5例,且可见随时间推移静脉窦密度减低;DSA证实,上矢状窦闭塞15例,单侧横窦闭塞8例,乙状窦闭塞7例,直窦闭塞4例,下矢状窦闭塞2例。结论脑静脉窦闭塞的影像表现与动脉性闭塞完全不同。CT和MR检查对诊断脑静脉窦闭塞具有重要意义,DSA仍为诊断该病的金标准。
Objective To explore the imaging manifestations of cerebral venous sinus thrombosis and further improve the understanding of this disease. Methods A retrospective analysis of 36 cases of cerebral venous sinus thrombosis imaging (including MRI, CT and DSA) data, 15 males and 21 females, aged from 23 to 59 years. Results There were 26 cases of abnormal signals in the parenchyma of T1 weighted images and T2 weighted images of MR. Among them, there were 16 cases with intracerebral hemorrhage complicated with long T1 and long T2 abnormal signals, 6 cases with long T1 and long T2 signals, and 4 cases with ventricular enlargement, 4 cases of brain swelling, showing sulci, pool narrowing. 25 cases of cerebral venous sinus is not enhanced, but abnormal enhancement of cortical veins. 10 cases of brain swelling and bleeding on CT, 5 cases of cerebral ischemia with low density, and visible decrease of venous sinus density over time; DSA confirmed that the superior sagittal sinus occlusion in 15 cases, unilateral transverse sinus occlusion in 8 cases , Sigmoid sinus occlusion in 7 cases, straight sinus occlusion in 4 cases, and sagittal sinus occlusion in 2 cases. Conclusion Cerebral venous sinus occlusion is completely different from arterial occlusion. CT and MR examination for the diagnosis of cerebral venous sinus occlusion is of great significance, DSA is still the gold standard for the diagnosis of the disease.