颈内静脉病变与颅内静脉窦血栓形成关系的研究  

Relationship between internal jugular vein abnormalities and cerebral venous sinus thrombosis

作　　者：贾凌云[1] 华扬[1] 吉训明[2] 刘江涛[3] 

机构地区：[1]首都医科大学宣武医院血管超声科,北京100053 [2]首都医科大学宣武医院神经外科,北京100053 [3]首都医科大学宣武医院放射科,北京100053

出　　处：《中国脑血管病杂志》2012年第12期652-655,共4页Chinese Journal of Cerebrovascular Diseases

基　　金：国家自然科学基金青年科学基金资助项目(81200912);教育部高等学校博士学科点专项科研基金(20111107110012)

摘　　要：目的探讨颈内静脉(IJV)病变与颅内静脉窦血栓形成(CVST)发生的关系。方法回顾性纳入2010年10月—2012年7月在首都医科大学宣武医院就诊的经核磁共振静脉造影和(或)DSA检查,并经临床确诊的CVST患者89例。应用彩色多普勒血流显像(CDFI)检测双侧IJV不同部位的管径、最大血流速度(Vmax)及反流时间。分析CVST患者IJV病变的类型及特点,比较不同病变组的IJV结构和血流动力学参数。结果①89例患者中,IJV正常者25例(28.0%),异常者64例(72.0%)。IJV病变类型包括局限性狭窄(39例,60.9%),长段纤细(17例,26.6%),血栓形成(5例,7.8%)及瓣膜异常(3例,4.7%)。②IJV病变侧别与CVST侧别完全一致者占76.6%(49/64),单侧IJV病变发生双侧CVST者占6.2%(4/64),双侧IJV病变发生单侧CVST者占17.2%(11/64);无一例IJV病变侧别与CVST侧别颠倒者。③在单侧IJV狭窄性病变(局限性狭窄和长段纤细)的43例患者中,狭窄处的最小管径均明显低于对侧,差异有统计学意义,P<0.01。单侧IJV局限性狭窄组的Vmax明显高于对侧[(109±42)cm/s比(70±33)cm/s,P=0.0002)],而单侧长段纤细组的Vmax显著低于对侧[(39±24)cm/s比(73±36)cm/s,P=0.004)]。④CVST患者中,IJV正常组与异常组IJV是否存在反流及反流时间差异无统计学意义。结论 IJV病变与CVST发生有关,其可能是CVST的危险因素之一。Objective To investigate the relationship between internal jugular vein （IJV） abnormal- ities and the occurrence of cerebral venous sinus thrombosis （CVST）. Methods A total of 89 patients with CVST treated at the Department of Neurosurgery, Beijing Xuanwu Hospital, Capital Medical University and diagnosed by magnetic resonance venography （MRV） and/or digital subtraction angiography （DSA） from October 2010 to July 2012 were enrolled retrospectively. Color Doppler flow imaging （CDFI） was used to detect the diameters of bilateral LIV at different parts （ J1, J2, and J3 ）, the maximum velocity （Vmax） , and the reflux time. The types and characteristics of the IJV abnormalities in patients with CVST were analyzed, and the IJV structure and hemodynamic parameter values were compared in different lesion groups. Results ①Of the 89 patients, IJV was normal in 25 （28.0%） and IJV was abnormal in 64 pa-tients （72.0%）. The types of IJV abnormalities included localized stenosis （n = 39, 60.9% ）, hypoplasia （n=17, 26.6%）, thrombosis （n=5, 7.8%）, and anomalous valve （n=3, 4.7%）. ②The sides of IJV abnormalities were completely consistent with those of CVST, accounting for 76.6% （49/64）. The patients with unilateral IJV abnormalities occurred bilateral CVST, accounting for 6.2% （4/64） and those with bilateral IJV abnormalities occurred unilateral CVST, accounting for 17.2% （11/64）. None of lesion side reversed with that of CVST. ③Among the 43 patients with unilateral IJV abnormalities （ localized ste-nosis and hypoplasia）, the minimum diameter at the stenosis was significantly smaller than that at the con-tralateral side （ P 〈 0.01 ）. The Vmax in a localized stenosis group was significantly higher than the contra-lateral side （ 109 ± 42 cm/s vs. 70 ± 33 cm/s,P = 0. 0002）, and the Vmax in a unilateral hypoplasia group was significantly lower than that in the contralateral side （39 ± 24 cm/s vs. 73 ± 36 cm/s, P= 0. 004）. ④In CVST patients,

关 键 词：窦血栓形成 颅内 颈静脉 危险因素 超声检查 多普勒 彩色 血流动力学 

分 类 号：R743[医药卫生—神经病学与精神病学]