Doege C A, Tavakolian R, Kerskens C M, Romero B I, Lehmann R, Einhäupl K M, Villringer A
Klinik und Poliklinik für Neurologie, Universitätsklinikum Charité, Medizinische Fakultät der Humboldt-Universität zu Berlin, Germany.
J Neurol. 2001 Jul;248(7):564-71. doi: 10.1007/s004150170133.
Diagnosis of cerebral venous thrombosis (CVT) is usually achieved by digital subtraction angiography or magnetic resonance angiography, while structural brain tissue damage can be assessed by computed tomography or magnetic resonance imaging (MRI). Using perfusion and diffusion weighted imaging (PWI, DWI) we aimed in this study to identify pathophysiological patterns corresponding to only functional and hence reversible tissue involvement.
PWI, DWI, and conventional MRI were performed in six CVT patients acutely and after 16-26 days when their clinical condition had improved. All patients were treated with partial thromboplastin time-effective intravenous heparin. After intravenous administration of a paramagnetic contrast agent, bolus track PWI allows pixel based determination of mean transit time (MTT) and cerebral blood volume (CBV). DWI was performed with two different b values (0, 1000 s/mm2) for calculation of apparent diffusion coefficient (ADC) maps.
In five of six cases increased MTT values were observed initially, whereas the CBV was normal, indicating a reduction of cerebral blood flow. ADC values were normal. On follow up after clinical recovery MTT prolongations had resolved. Areas with prolonged MTT did not evolve into structural lesions.
In patients with CVT, prolongations of MTT in the absence of changes in CBV and ADC seem to indicate reversible involvement of brain tissue, a situation corresponding to the ischaemic penumbra.
脑静脉血栓形成（CVT）的诊断通常通过数字减影血管造影或磁共振血管造影来实现，而脑组织的结构损伤可通过计算机断层扫描或磁共振成像（MRI）进行评估。在本研究中，我们使用灌注加权成像和扩散加权成像（PWI、DWI）来识别仅对应于功能性且因此可逆的组织受累的病理生理模式。
对6例CVT患者在急性期以及临床症状改善后的16 - 26天进行PWI、DWI和传统MRI检查。所有患者均接受部分凝血活酶时间有效的静脉肝素治疗。静脉注射顺磁性造影剂后，团注追踪PWI可基于像素确定平均通过时间（MTT）和脑血容量（CBV）。DWI采用两种不同的b值（0，1000 s/mm2）进行，以计算表观扩散系数（ADC）图。
6例患者中有5例最初观察到MTT值升高，而CBV正常，表明脑血流量减少。ADC值正常。临床恢复后的随访中，MTT延长已消失。MTT延长的区域未演变为结构性病变。
在CVT患者中，CBV和ADC无变化而MTT延长似乎表明脑组织存在可逆性受累，这种情况与缺血半暗带相符。
