静脉性脑梗死的多模态MRI诊断价值分析  

Analysis of the diagnostic value of multimodal MRI in cerebral venous infarction

作　　者：李恒 张明[1] 牛璇[1] 韩月东 陈利军 蒋士杰 LI Heng;ZHANG Ming;NIU Xuan;HAN Yuedong;CHEN Lijun;JIANG Shijie(Medical Imaging Department,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061;Radiology Department,Xi'an Gaoxin Hospital,Xi'an 710075;Medical Imaging Center,Xi'anPeople's Hospital/Xi'an Fourth Hospital,Xi'an 710004,China)

机构地区：[1]西安交通大学第一附属医院医学影像科,陕西西安710061 [2]西安高新医院放射科,陕西西安710075 [3]西安市人民医院/西安市第四医院医学影像中心,陕西西安710004

出　　处：《临床医学研究与实践》2024年第17期109-112,共4页Clinical Research and Practice

基　　金：中国红十字基金会“影瑞西北公益行”之ICON科研基金项目(No.XM_HR_ICON_2020_10)。

摘　　要：目的探讨静脉性脑梗死(CVI)的多模态MRI征象及其诊断价值,以提高CVI诊断准确率。方法回顾性分析12例CVI患者的多模态MRI表现,并复习相关文献。结果6例MRI平扫表现为病变区皮层及皮层下脑肿胀,T_(1)加权成像(T_(1)WI)呈片状低信号或等信号,T_(2)加权成像(T_(2)WI)呈高信号,病灶部位大多表浅,靠近皮层,位于非动脉供血区域,增强扫描其中2例急性期病变表现为条片样或脑回样强化,4例未强化;5例位于双侧丘脑、基底节区,病变较对称,增强扫描呈斑片状较显著强化;1例位于脑干及小脑半球,增强扫描呈斑片状较显著强化。12例弥散加权成像(DWI)血管源性水肿期均表现为等信号或稍高信号,随病情进一步发展,出现细胞毒性水肿,DWI表现为高信号;4例磁敏感加权成像(SWI)显示病变区有出血、静脉扩张、血栓等情况;12例磁共振静脉成像(MRV)均显示病变区相应引流静脉内血栓形成。结论多模态MRI扫描可提高CVI的诊断准确率,为临床治疗提供影像学依据。Objective To explore the multimodal MRI signs of cerebral venous infarction(CVI)and its diagnostic value in order to improve the diagnostic accuracy of CVI.Methods The multimodal MRI findings of 12 patients with CVI were retrospectively analyzed and the related literatures were reviewed.Results Six cases showed cortical and subcortical brain swelling in the lesion area on plain scanning of MRI,with patchy low signal or equal signal on T_(1) weighted image(T_(1)WI)and high signal on T_(2) weighted image(T_(2)WI),and the lesion sites were mostly superficial,close to the cortex,and located in the area of non-arterial blood supply.The enhancement scans of two of the cases showed striated patchy or gyri-like enhancement in the acute stage,and 4 cases showed no enhancement;5 cases were located in the bilateral thalamus and basal ganglia,with more symmetrical lesions and more significant patchy enhancement on enhanced scan;1 case was located in the brainstem and cerebellar hemispheres,and showed more significant patchy enhancement on enhanced scan.Twelve cases of vasogenic edema showed equal signal or slightly high signal on diffusion weighted imaging(DWI),as the disease progressed,cytotoxic edema appeared,and the DWI showed high signal;4 cases of susceptibility weighted imaging(SWI)showed hemorrhage,venous dilatation and thrombus in the lesion area;12 cases of magnetic resonance venography(MRV)showed thrombosis in the corresponding draining vein in the lesion area.Conclusion Multimodal MRI scanning can improve the diagnostic accuracy of CVI and provide imaging basis for clinical treatment.

关 键 词：静脉性脑梗死 MRI 磁共振静脉成像 弥散加权成像 磁敏感加权成像 

分 类 号：R74[医药卫生—神经病学与精神病学]