MRI结合MRV技术对颅内静脉窦血栓检出的应用价值  

The value of MRI combined with MRV technique in the detection of intracranial venous sinus thrombosis

作　　者：刘海博[1] 黄兴[1] 姜微[1] Liu Haibo;Huang Xing;Jiang Wei(Department of Radiology,Jilin Provincial People＇s Hospital,Changchun 130021,China)

机构地区：[1]吉林省人民医院放射科,长春130021

出　　处：《血管与腔内血管外科杂志》2018年第1期57-61,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的分析常规磁共振成像(MRI)结合磁共振静脉血管成像(MRV)在颅内静脉窦血栓(CVST)检出中的应用价值。方法收集本院34例经数字减影血管造影(DSA)确诊为CVST患者的临床资料,所有患者确诊前均行MRI及MRV检查,对比分析两者对本病的检出及显示情况。结果 MRI结合MRV对本病的检出率达88.4%,病变累及部位最多为上矢状窦。结合增强扫描后达97.7%,仅1例下矢状窦血栓出现漏诊。MRI可清晰显示CVST的直接征象,急性期平扫及增强扫描显示病变段静脉窦内流空效应消失,而表现为血栓的混杂信号,亚急性期T1WI及T2WI均呈高信号,增强扫描显示血管管腔内出现充盈缺损。间接征象如相邻脑实质出血和水肿等。MRV则可直观显示血栓段管腔的形态,以及分支血管扩张程度和侧支血管情况;本组18例分别于发病后12 d、3个月后进行MRI和MRV复查,其中8例血栓完全吸收,阻塞的静脉窦完全再通。5例患者血栓部分吸收,阻塞段窦壁毛糙不光滑,管腔局限性狭窄。5例患者血栓逐渐钙化,阻塞段血管旁侧枝血管形成。结论 MRI和MRV技术各有优势,两者联合应用对CVST的检出和病变程度的判断有着重要的临床价值。对于临床高度疑似CVST患者应结合MR增强扫描,以免漏诊。Objective To analyze the application value of conventional magnetic resonance imaging（MRI） combined with magnetic resonance venous angiography（MRV） in the detection of intracranial venous sinus thrombosis（CVST）. Methods 34 cases collected in our hospital by the digital subtraction angiography（DSA） diagnosis of the clinical data of patients with CVST, all patients were performed MRI and MRV examination before diagnosis, comparison and analysis of the disease detection and display of the two. Results The detection rate of MRI combined with MRV was 88.4%, and the lesion was the most in the upper sagittal sinus. Combined with an enhanced scan of 97.7%, only 1 case of lower sagittal sinus thrombosis was missed. MRI can clearly show the direct signs of CVST, acute phase scan and enhanced scan showed lesions within the period of venous sinus flow void disappeared, and show the thrombus mixed signals, are in high signal the subacute phase of T1 WI and T2 WI, enhanced scan showed filling defect within the vascular lumen. Indirect signs such as adjacent cerebral parenchyma hemorrhage and edema. MRV can directly show the morphology of the vascular cavity of the thrombus, as well as the degree of vascular dilatation and collateral vessels. In this group, 18 patients underwent MRI and MRV reexamination after 12 days and 3 months after onset, of which 8 cases were completely absorbed by thrombus, and the blocked venous sinus was completely reconnected. In 5 patients, the thrombus was absorbed, and the wall of obstruction was not smooth, and the lumen was limited. In 5 patients, the thrombus gradually calcified, blocking the side of the vessel and forming the collateral vessels. Conclusion MRI and MRV technology have advantages, and the combined application of 2 patients has important clinical value in the diagnosis of CVST and the degree of lesion. For clinically highly suspected patients with CVST, it should be combined with MR enhancement scanning to avoid missed diagnosis.

关 键 词：磁共振成像 磁共振静脉血管成像 静脉窦血栓 联合应用 

分 类 号：R322.13[医药卫生—人体解剖和组织胚胎学]