孕产妇颅内静脉窦血栓形成的CT、MRI、MRV、DSA诊断  

The Diagnosis of CT,MRI,MRV and DSA in Cerebral Venous Sinus Thrombosis during Pregnancy and Puerperium

作　　者：马英[1] 宋利春[1] 李琦[2] 潘诗农[2] 尚涛[3] 

机构地区：[1]中国医科大学附属盛京医院神经内科,沈阳市110004 [2]中国医科大学附属盛京医院放射科,沈阳市110004 [3]中国医科大学附属盛京医院妇产科,沈阳市110004

出　　处：《中国医学影像学杂志》2009年第2期142-145,共4页Chinese Journal of Medical Imaging

摘　　要：目的:探讨头部影像学检查诊断孕产妇颅内静脉窦血栓形成(CVST)的价值。材料和方法:回顾性分析6例孕产妇并发CVST患者CT、MRI、MRV、DSA成像的直接和间接征象。6例患者起病后头部CT扫描5例、MRI扫描6例、MRV扫描4例、MRI增强扫描3例、DSA检查1例。结果:6例患者的头部CT、MRI、MRV、DSA成像均有异常表现。表现脑叶皮质及皮质下白质受累间接征象的CT5例、MRI6例,其中出血性梗死4例。同时表现纵裂内高密度索带征及高密度三角征直接征像的CT1例,表现静脉窦流空信号消失、T1为等信号、T2为等及低信号直接征像的MRI2例。表现受累静脉窦不显影、显影中断、显示不清、或者局部信号缺失的MRV4例,其中1例表现出两侧静脉分枝显影不均,一侧静脉分枝显影明显减少的征象。显示上矢状窦不显影的DSA1例。结论:头部CT、MRI、MRV和DSA检查能显示CVST脑组织直接和间接受累征像,MRI+MRV成像可作为诊断CVST的首选检查,CT及MRI+MRV复查能动态观察病情及反映疗效。Purpose： To investigate the imaging diagnostic value of head imaging examination in cerebral venous sinus thrombosis （CVST） during pregnancy and puerperium. Materials and Methods： Six cases of CVST during pregnancy and puerperium with the clinical findings and the direct and indirect signs of CT, MRI, MRV and DSA were analysed retrespectively. After the onset in 6 patients ,5 cases underwent CT, 6 cases underwent MRI,3 cases underwent MRI-enhanced,4 cases underwent MRV, 1 case underwent DSA. Results： All 6 patients had abnormal imaging in brain CT, MRI, MRV and DSA. 5 cases CT and 6 cases MRI showed involvement signs of cerebral cortex and subcortical white matter, 4 cases of them showed hemorrhagic infarction. At the same time 1 case showed direct sign of hyperdensity cord sign and triangle sign in longitudinal fissure in CT. 2 cases showed direct sign of disappearing of the disappeared blood flow signal in the si- nus in MRI. 4 cases demonstrated signal loss, signal interruption, unclear or partial signal loss of involved sinus in MRV. One of them also displayed uneven image on both sides of the branching vein, signal in one side branches significantly decreased compared to the other side less. 1 case didn＇ t show imaging in superior sagittal sinus in DSA. Conclusions： The brain imaging examination could show direct and indirect signs of involved brain tissue in CVST. MRI ＋ MRV could be used as the preferred inspection to diagnose CVST. Reexamination of CT and MRI ＋ MRV could provide dynamic observation of the illness and reflect the effect of treatment.

关 键 词：孕产妇 颅内静脉窦血栓形成 CT MRI MRV DSA 

分 类 号：R816.1[医药卫生—放射医学]