磁敏感加权成像(SWI)联合磁共振静脉成像(MRV)在脑静脉窦血栓形成(CVST)早期诊断中的临床应用价值  

Clinical Value of Magnetic Susceptibility Weighted Imaging Combined with Magnetic Resonance Venography in Early Diagnosis of Cerebral Venous Sinus Thrombosis

作　　者：李俊彤 彭琨[1] Li Juntong;Peng Kun(The Sixth Hospital of Shanxi Medical University,Taiyuan,Shanxi 030001)

机构地区：[1]山西医科大学第六医院,山西太原030001

出　　处：《现代医用影像学》2024年第6期995-997,1002,共4页Modern Medical Imageology

摘　　要：目的:本研究旨在探讨磁敏感加权成像(susceptibility weighted imaging,SWI)联合磁共振静脉成像(magnetic resonance venography,MRV)对脑静脉窦血栓形成(cerebral venous sinus thrombosis,CVST)早期(急性期和亚急性期)诊断的临床应用价值。方法:回顾性分析2010年至2021年间我院收治的早期CVST患者。所有患者均行MRI及数字减影血管造影(digital subtraction angiography,DSA)检查,MR序列包括T1WI、T2WI、FLAIR、MRV和SWI。诊断金标准为头颅DSA检查。各检查序列发现CVST阳性表现,采用卡方检验分别对SWI、MRV和常规MR序列进行统计学分析。结果:本研究66例CVST患者均由头颅DSA确诊,累及上矢状窦17例,横窦9例,累及多静脉窦40例。DSA图像中发现了118个静脉窦血栓形成节段,常规MR(T1WI、T2WI、FLAIR)发现73(61.9%)个,MRV发现118(100%)个。66例患者中,SWI扫描100%(66/66)发现了小静脉扩张和迂曲引流静脉,明显高于MRV扫描71.2%(47/66)(P<0.001)和常规磁共振扫描47.0%(31/66)(P<0.001)。66例患者中SWI显示77.3%(51/66)有微出血灶,明显高于常规MR扫描43.9%(29/66)(P<0.05)。结论:MRV对CVST的早期诊断比常规MR序列更敏感,可以与DSA结果相媲美,SWI可检测梗死灶处扩张的小静脉、迂曲的引流静脉和点状微出血灶,SWI联合MRV在早期CVST临床诊断中具有重要价值。Objective:The purpose of this study was to evaluate the clinical value of magnetic susceptibility weighted imaging(SWI)combined with magnetic resonance venography(MRV)in the diagnosis of early cerebral venous sinus thrombosis(CVST:acute and subacute).Methods:The patients with early CVST treated in our hospital from 2010 to 2021 were analyzed retrospectively.All patients were examined by MRI and digital subtraction angiography(DSA).The MR sequence included TIWI,T2WI,FLAIR,MRV and SWI.The gold standard of diagnosis was cranial DSA examination.Positive CVST was found in each sequence,and chi-square test was used to analyze SWI,MRV and conventional MR sequences.Results:All 66 CVST patients in this study were diagnosed by cranial DSA,involving 17 cases of superior sagital sinus,9 cases of transverse sinus,and 40 cases of multiple venous sinus.118 segments of venous sinus thrombosis were found on DSA images,73(61.9%)were found on conventional MR(T1 WI,T2WI,FLAIR),and 118(100%)were found on MRV.Among the 66 patients,100%(66/66)of SWI scans showed dilated and tortuous drainage veins,significantly higher than 71.2%(47/66)of MRV scans(P<0.001)and 47.0%(31/66)of conventional magnetic resonance scans(P<0.001).Among 66 patients,SWI showed 77.3%(51/66)of them had microbleeding lesions,significantly higher than conventional MR scanning of 43.9%(29/66)(P<0.05).Conclusion:MRV is more sensitive to the early diagnosis of CVST than conventional MR sequences and can be comparable to DSA results.SWI can detect dilated small veins,tortuous drainage veins,and punctate microbleeds at the infarct site.The combination of SWI and MRV has important value in the clinical diagnosis of early CVST.

关 键 词：磁敏感加权成像 磁共振静脉成像 脑静脉窦血栓形成 

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]