摘要
目的探讨MSCT静脉成像(MSCTV)在诊断脑静脉窦血栓中的价值,以期为临床诊断脑静脉窦血栓提供一种更加简单、可靠的检查手段。方法对32例脑静脉窦血栓形成的患者进行38次MSCT双期血管成像(复查6例),即动脉期及静脉期(CTA+CTV),由3位影像科高年资医师对图像进行独立分析,综合一致的意见作为诊断结果,以MRI+MRV和/或DSA结果结合临床最终诊断作为判断诊断准确性的标准。结果横断面增强扫描清晰显示受累的静脉窦内无对比剂充填,窦壁较明显强化,上矢状窦及乙状窦表现为典型的三角形充盈缺损区,即空三角征,横窦及直窦血栓表现为带状充盈缺损区,冠状及矢状位MPR可以很清晰显示病灶。MSCTV图像更能直观地显示窦内充盈缺损区,与MRV或DSA图像完全一致,扩张的脑表面静脉MSCTV也能很好显示,同时可显示脑实质内的静脉性脑水肿和静脉性脑梗死及伴随的出血灶。结论 MSCTV可以清晰显示脑静脉窦血栓的影像特征,且较DSA及MRV简单、易行,可作为临床上可疑病例可靠的影像学检查手段。
Objective To evaluate the value of MSCTV in the diagnosis of cerebral venous sinus thrombosis（CVST ） ,in an attempt to provide a simple but more effective imaging method in the evaluation of cerebral venous sinus thrombosis clinically . Methods 32 patients with cerebral venous sinus thrombo-sis underwent biphasic contrast-enhanced CT scan （i .e .arterial and venous phases or CTA＋CTV） using a MSCT scanner （follow-up CT in 6 cases） ,with a total of 38 MSCT examination being performed . The data were independently analyzed by three experienced radiologists and CT-based diagnosis was made when there is a consensus among the three radiologists . T he criteria of diagnostic accuracy ,based on the re-sults of MRI＋ MRV and/or DSA correlating with clinilal diagnosis ,was used . Results Filling defect was seen within the involved venous sinuses on axial contrast-enhanced CT images and moderate enhance-ment of the sinal wall was significantly observed . Triangular area of filling defects is the typical feature of superior sagittal sinus and sigmoid sinus thrombosis , w hich termed as ＂empty triangle sign＂, and thrombosis in the transverse and straight sinuses manifested as girdle-shaped filling defect ,which was clearly revealed on coronal and sagittal MPR . MSCTV is capable of demonstrating filling defect within sinus ,competing with MRV or DSA . MSCTV possess ,to a considerable degree ,the ability to depict the dilated superficial cerebral veins ,as well as the cerebral venous edema and/or infarction with or without hemorrhage . Conclusion MSCTV can clearly display the image characteristics of CVST . Compared to MRV or DSA ,it is simple and feasible and becoming a reliable imaging method for screening patients with suspected CVST .
出处
《福建医科大学学报》
2014年第4期273-276,共4页
Journal of Fujian Medical University
