摘要
目的探讨大脑皮质浅静脉血栓的CT、MRI和数字减影血管造影(DSA)的特点。方法收集大脑皮质浅静脉血栓形成患者9例,均行常规头部CT和MRI检查;7例同时行脑MR静脉造影;6例行静脉期脑DSA。2例行经导管静脉窦溶栓术;2例行探查及血肿清除术。回顾性分析这些病例的影像学资料,与临床表现对照,总结其具有诊断意义的征象。结果9例均为大脑上静脉血栓形成,其中单侧6例,双侧3例;2例为单纯大脑上静脉血栓形成,7例合并上矢状窦血栓,其中2例合并横窦、乙状窦血栓形成。8例并发皮质脑实质病变,其中3例为静脉脑梗死,5例为出血性静脉脑梗死。2例CT见高密度束带征,5例MRI静脉内血栓呈高亮信号。7例MR静脉造影可见病变区域皮质引流静脉稀少或缺如,以及向深静脉或其他皮质浅静脉的侧支引流。6例DSA均见病变区域皮质浅静脉充盈延迟,引流静脉稀少、缺如,以及向深静脉或经皮质浅静脉侧支的引流,2例可见病变浅静脉引流入上矢状窦前“截断”征象。结论CT、MRI及DSA是诊断大脑皮质浅静脉血栓形成的有效方法,其典型改变对诊断具有重要意义。
Objective To investigate the characteristics of CT, MRI and DSA of superficial cortical vein thrombosis. Methods Nine patients with superficial cortical vein thrombosis were collected. They all underwent CT and MRI examination. Seven patients received magnetic resonance venography （MRV） at the same time, and 6 performed venous phase DSA. Two patients received transcatheter venous sinus thrombolysis, and 2 patients received surgical exploration and removal of hematomas. As compared with the clinical profile, these imaging data were analyzed retrospectively, and the significant diagnostic features were summarized. Results All the 9 patients had superior cerebral vein thrombosis, 6 presented on one side, and 3 on both sides. Two patients had superior cerebral vein thrombosis only, 7 complicated with superior sagittal sinus thrombosis, and 2 of them also with transverse sinus and sigmoid sinus thrombosis. Eight patients complicated with cortical parenchymal lesions, 3 of them had cerebral infarction, and 5 had hemorrhagic cerebral infarction. CT image showed dense cord sign in 2 patients, and MRI displayed high bright signal in intravenous thrombus in 5 patients. MRV showed sparsity or absence of the cortical draining veins, and collateral drainage towards deep veins or other superficial cortical veins in the diseased regions in 7 patients. DSA revealed filling delay in the superficial cortical veins, sparsity or absence of the draining veins, and collateral drainage towards deep veins or superficial cortical veins in 6 patients in the diseased regions. The ＂cut＂ sign could be observed before the abnormal superficial veins drainage into the superior sagittal sinus in 2 patients. Conclusion CT, MRI and DSA are the effective methods in the diagnosis of cerebral superficial cortical vein thrombosis, and its typical changes have crucial significance for the diagnosis.
出处
《中国脑血管病杂志》
CAS
2007年第2期64-67,共4页
Chinese Journal of Cerebrovascular Diseases
