脑静脉窦血栓形成的影像学特征分析

目的探讨脑静脉窦血栓(CVST)形成的电子计算机断层扫描(CT)及磁共振成像(MRI)表现特征。 方法回顾性分析2014年11月至2018年3月，江苏省丰县人民医院神经内科收治的14例CVST患者的临床及影像学资料。所有患者均行CT及MRI平扫，3例行MRI增强扫描，5例行磁共振静脉血管成像(MRV)，2例行磁共振动脉血管成像(MRA)。观察CVST累及区域范围及周围情况、平扫密度或信号特征及颅内伴发病变等。 结果全部患者均累及2个以上静脉窦，7例患者CT平扫见受累静脉窦明显高密度，MR平扫10例患者可见受累静脉窦T1WI明显高信号或混杂信号，T2WI及FLAIR均可见受累静脉窦高信号。3例行MRI增强扫描患者中，受累及静脉窦呈完全强化2例，部分性强化1例。CT及MRI提示左颞叶出血性梗死1例，矢状窦旁占位2例，丘脑出血性梗死1例，皮层蛛网膜下腔出血2例。MRV均可见受累静脉窦显影不规则、狭窄或完全不显影及侧支代偿血管形成。 结论MRI平扫可显示CVST的特征，CT平扫部分患者显示CVST的特征，CT及MRI平扫均可显示CVST的颅内伴发病变。识别CVST的静脉窦CT及MRI平扫特征及可能的颅内继发病变影像学表现，并结合MRV检查有助于准确诊断。

Imaging feature analysis of cerebral venous sinus thrombosis

ObjectiveTo explore the CT and MRI features of cerebral venous sinus thrombosis (CVST). MethodsFrom November 2014 to March 2018, the clinical and imaging data of 14 patients with CVST diagnosed by clinical follow-up in the Department of Neurology of Fengxian People′s Hospital were retrospectively analyzed. All patients underwent plain CT and plain MR scan, 3 patients also underwent MRI enhancement scans, 5 patients had MRV and 2 patients had MRA examination data. The involvement area and surrounding conditions, plain scan density or signal characteristics and intracranial associated changes of the CVST were observed. ResultsAll cases involved more than 2 sinusoids. Plain MRI revealed a hyperintense signal on T2WI and FLAIR in the affected sinuses in all patients, 7 patients were found with high density in the affected sinuses in the plain CT scan, and a hyperintense signal or mixed signal on the T1WI in the involved sinuses in 10 cases. The features of the three enhanced MRI cases were partial enhancement (n=1) and complete enhancement (n=2). CT and MRI revealed 1 case of hemorrhagic in left temporal lobe 2 cases of space-occupying lesions parasagittal meningiomas, 1 case of hemorrhagic infarction in thalamic and 2 cases of cortical subarachnoid hemorrhage. MRV showed that the involved venous sinuses were irregularly developed, stenosis or completely undeveloped, and collateral compensatory vascularization. ConclusionsCVST can be displayed by MRI and be partially displayed by CT, and its possible intracranial lesions can be displayed by CT or MRI. Recognizing the characteristics of CVST in the responsible venous sinus and its possible intracranial lesions on plain CT and plain MRI and combining with MRV examination are helpful for accurate diagnosis.