颅内静脉窦血栓形成患者蛛网膜颗粒的MRI研究  

MR imaging study of arachnoid granulation in patients with cerebral venous sinus thrombosis

作　　者：李克磊 魏梁锋 望家兴 范雅操 吴箭午 李军 鲜亮 王守森 Li Kelei;Wei Liangfeng;Wang Jiaxing;Fan Yacao;Wu Jianwu;Li Jun;Xian Liang;Wang Shotusen(Department of Neurosurgery,900th Hospital of Joint Logistics Team,Fuzhou 350025,China)

机构地区：[1]解放军联勤保障部队第九○○医院神经外科,福州350025

出　　处：《中华神经医学杂志》2020年第8期770-774,共5页Chinese Journal of Neuromedicine

基　　金：福建省科技计划引导性项目(2018Y0067)。

摘　　要：目的探讨颅内静脉窦血栓(CVST)形成患者蛛网膜颗粒(AG)的改变情况及其影像学特征。方法选择解放军联勤保障部队第九OO医院神经外科自2013年1月至2018年12月收治的35例自发性CVST患者进人研究,归为CVST组;同时选择相同时间段来我院进行体检的35例健康体检者为对照组。比较2组成员AG大小及数量,分析不同病程CVST患者CVST与AG的MRI特征。结果(1)35例CVST患者中14例发现AG,直径为(5.19±2.40)mm,范围为1.83~11.77 mm;35例对照组成员中23例发现AG,直径为(4.45±2.03)mm,范围为1.45-9.87 mm。2组成员的AG检出率差异有统计学意义(χ2=4.644,P=0.031),AG直径差异无统计学意义(t=2.121,P=0.221)。(2)8例急性期CVST患者CVST MRI表现为T2WI低信号,FLAIR低信号;20例亚急性期CVST患者CVST T2WI、FLAIR均呈高信号;7例慢性期CVST患者CVST T2WI呈高信号,FLAIR星高信号;3种不同病程患者AG均表现为T2WI高信号,FLAIR低信号。结论CVST患者中AG检出率较正常对照者低;MRIT2WI和FLAIR序列能够有效鉴别CVST与AG。Objective To study the changes and imaging features of arachnoid granulation(AG)in patients with cerebral venous sinus thrombosis(CVST).Methods The clinical and imaging data of 35 patients with idiopathie CVST confirmed by MR imaging combined with CE-MRV or DSA in our hospital from January 2013 to December 2018,and 35 healthy controls collcted at the physical examination center at the same time period were detected.The sizes and numbers of AG were compared between the two groups,and the MR imaging features of CVST and AG in patients with CVST at different courses were compared.Results(1)In 35 patients with CVST,AG was found in 14 patients,and the average diameter was(5.19±2.40)mm,ranged from 1.83-11.77 mm;in the control group,AG was found in 23 patients,and the average diameter was(4.45±2.03)mm,ranged from 1.45-9.87 mm;no statistical difference was noted in diameter between the two groups(t=2.121,P=0.221),and the number of AG showed statistical difference between the two groups(xt-4.644,P=0.031).(2)In 8 patients with CVST at acute phase,CVST showed hypointense on T2WI and FLAIR;in 20 patients with CVST at subacute phase,CVST showed hyperintense on T2WI and FLAIR;in 7 patients with CVST at chronice phase,CVST showed hyperintense on T2WI and FLAIR.At any stage of venous sinus thrombosis,AG showed high signal on T2WI and low signal on FLAIR.Conclusion AG detection rate in CVST patients is lower than that in normal controls;MR imaging T2WI and FLAIR sequences could effectively distinguish CVST with AG.

关 键 词：静脉窦血栓 蛛网膜颗粒 对比增强磁共振静脉成像 鉴别诊断 

分 类 号：R743.32[医药卫生—神经病学与精神病学]