磁共振对颅内静脉窦阻塞性疾病的诊断价值

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1、磁共振对颅内静脉窦阻塞性疾病的诊断价值作者：刘奉立于本霞苏续清岳凤斌邹萍潘英华［摘耍］目的探讨颅内静脉窦阻塞性疾病(CVSOD)在磁共振(MRI)不同成像方法中表现，特别是CVSOD直接征象的敏感性及特异性。方法收集我院2001年12月〜2004年5月经临床、手术证实的CVSOD病人共14例，对其MRT表现，主要是对不同成像序列的平扫、磁共振静脉成像(MRV)及增强扫描图像(CE-MRI)中的直接征象进行分析;并随机抽取无CVSOD临床症状、有颅内静脉窦流空效应减弱征象的29例病人作为对照组进行对比分析。结杲在各种平扫成像序列中

2、，除T2WI两组间信号强度差别无显著意义外，其余各序列，包括T1WI、FIJHR、DWT以及MRV,两组间信号强度差别均有显著意义，以T1WT和DWI像两组间信号强度差别最为显著(uc=2.764〜5・729,P<O.05)o在CE-MRI,两组间信号强度差别无显著意义，但在形态上有明显差别。结论在MRI平扫序列中，T2WI对CVSOD造成的流空效应减弱较为敏感，但特异性较差;而T1WI及DWI特异性较高。MRV、CE-MRI中，形态的改变较信号改变对诊断CVSOD具有更重要的意义。［关键词］颅内静脉窦阻塞;颅内静脉窦血栓

3、;磁共振成像;诊断［ABSTRACT］ObjectiveToinvestigatethemanifestationsofcerebralvenoussinusCVSODocclusivcdiscascswithdiffe-rentmagneticresonanceimaging(MRI)methods,especiallythesensitivityandspecificityoftheimmediatesignsofthedisease・MethodsFourteencasesofCVSODconfirmedbyclinica

4、ldataorsurgicaloperationinourhospitalfromDecember2001toMay2004werereviewed・ThedirectsignsondifferentMRTsequencesofplainscan,on2D-T0F~MRVenography(MRV)andoncon-trastenhancedMRI(CE-MRI)wereanalyzed.Twenty-ninecaseswithdecreasedflow-voidinsinuseswereservedasthecontrols・

5、ResultsExceptforT2weightedimage(T2WI),thesignalintensitiesweresignifican11ydifferentbetweenthetwogroupsonmostofthesequencesofplainscan,includingTlweightedimage(T1WI),fastliquid-attenuationinversionrecovery(FLAIR)sequence,diffusionweightedimag(DWI)andMRV.Thedifference

6、sweremostsignificantinT1WTandDWT.Althoughthedifferenceinsig-nalintensitywasnotsignificantbetweenthetwogroupsonCE-MRI,theshapeofthedefectwasmarkedlydifferentbetweenthetwogroups・ConclusionOnplainscan,T2WTissensitivetothedecreasedflow—voideffeetcausedbyCVSOD,butthesigna

7、lchangeislessspecific・TlWIandDWIhavethehighestspecificityinthediagnosisofthedisease・OnMRVandCE-MRIthestudyoftheprofilechangeseemstobemoreimportantthanthealteredsignalintensitiesinthediagnosisofCVSOD.[KEYWORDS]cerebralvenoussinusocclusion;cerebralvenoussinusthrombosis

8、;magneticresonanceimaging;diagnosis颅内静脉窦阻塞性疾病(CVSOD)绝大多数是由于血栓或瘤栓形成所致，可造成脑部静脉回流障碍，继而引起脑水肿、颅内压增高等一系列病理生理改变。但由于血栓或瘤栓形成的快慢及累及的范围不同,临床表现