高分辨率核磁黑血成像技术评估颅内静脉及静脉窦血栓形成病程分期的价值  

Value of high-resolution magnetic resonance black-blood imaging for evaluation of the stage of disease in intracranial venous and sinus thrombosis

作　　者：杨旗[1] 杨晓旭[1] 段祥攻 吴芳[1] 武晔[1] 杜祥颖[1] 段建钢[2] 吉训明[3] 

机构地区：[1]北京首都医科大学宣武医院放射科,100053 [2]北京首都医科大学宣武医院急诊科,100053 [3]北京首都医科大学宣武医院神经外科,100053

出　　处：《中国脑血管病杂志》2017年第8期420-423,共4页Chinese Journal of Cerebrovascular Diseases

摘　　要：目的应用高分辨率MR黑血血栓成像(BTI)技术评价颅内静脉及静脉窦血栓形成(CVT)在病程分期中的价值。方法前瞻性纳入2015年6月至2016年10月首都医科大学宣武医院37例常规影像学检查确诊为CVT的患者,均另行BTI检查。根据临床症状出现至BTI检查时间,将患者分为急性组(≤14 d,23例)和慢性组(>15 d,14例)。测量BTI图像上检测到的血栓信号噪声比(SNR)和对比噪声比(CNR),比较两组血栓信号的差异。以MR静脉成像(MRV)检查结果作为参照,计算血管节段水平BTI诊断的准确性。结果 (1)血栓SNR在急性组和慢性组分别为206±97和94±41,CNR为201±96和86±40,两组比较差异有统计学意义(t值分别为4.9和5.0,均P<0.01)。(2)37例CVT患者中,MRV共检出159处脑静脉及静脉窦节段存在血栓,BTI在其中152处准确识别血栓,在352处排除血栓,诊断敏感度和特异度分别为95.6%(152/159)和98.0%(352/359)。结论 BTI技术实现脑静脉血栓直接成像,能够准确区分急性与慢性血栓,具有较高准确性。Objective To evaluate the value of magnetic resonance black-blood thrombus imaging （BTI） of the stage of disease in intracranial venous and sinus thrombosis（CVT）.Methods From June 2015 to October 2016,37 patients with CVT diagnosed with routine imaging examinations in Beijing Xuanwu Hospital,Capital Medical University were enrolled prospectively,and they also underwent BTI examination.The patients were randomly divided into either a acute group （≤14 d,n=23） or a chronic group （〉15 d,n=14） according to the time from the onset of symptoms to BTI.Signal to noise ratio（SNR） and contrast to noise ratio（CNR） difference between acute and chronic CVT groups were compared.The magnetic resonance venography （MRV） examination was used as a reference to calculate the accuracy of BTI on per-segment level.Results （1） The SNR and CNR of thrombosis in the acute group and chronic group were 206±97 and 94±41,201±96 and 86±40,respectively.There was significant difference between two groups （t=4.9 and 5.0 respectively;all P〈0.01）.（2） In 37 patients with CVT,the thrombi in 159 cerebral veins and venous sinus segments were detected with MRV.BTI identified the thrombi accurately in 152 vascular segments,and the thrombi in 352 vascular segments were eliminated.The diagnostic sensitivity and specificity were 95.6% （152/159） and 98.0% （352/359） respectively.Conclusion Achieving direct angiography of cerebral venous thrombosis,BTI technique can accurately differentiate acute or chronic thrombus.It has higher accuracy.

关 键 词：脑静脉及静脉窦血栓 磁共振成像 黑血血栓成像 颅内静脉血栓分期 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743[医药卫生—诊断学]