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婴儿颅内静脉经囟门多普勒超声检查。第二部分——病理学

[Trans-fontanellar Doppler sonography of the intracranial veins in infants. Part II--pathology].

作者信息

Deeg K-H, Lode H M

机构信息

Klinik für Kinder- und Jugendmedizin, Sozialstiftung Bamberg.

出版信息

Ultraschall Med. 2006 Apr;27(2):164-75. doi: 10.1055/s-2005-858883.

Abstract

Colour coded Doppler sonography can be very helpful for the diagnosis of haemorrhagic infarction of the brain parenchyma, cerebral venous thrombosis and arterio-venous malformations of the brain. Intracranial haemorrhages into the brain parenchyma are caused by the compression of the subependymal and terminal veins which impede the venous drainage from the white matter. Haemorrhage of the basal ganglia is highly suspicious of cerebral venous thrombosis especially of the deep venous drainage. Unilateral occlusion of only one internal cerebral vein causes unilateral haemorrhage, bilateral thrombosis of both internal cerebral veins as well as occlusion of the great vein of Galens or the straight sinus causes bilateral haemorrhage of the basal ganglia as well as ventricular haemorrhage and haemorrhagic infarction of the white matter. The most common arterio-venous malformation of the brain is AV-malformation of Galens's vein. Sonographically, a pulsating cystic structure behind the 3rd ventricle can be shown. Colour coded Doppler sonography demonstrates the vascular nature of the cyst. Doppler sonography can show the feeding arteries, most frequently the posterior choroidal arteries and the venous drainage by the straight sinus.

摘要

彩色编码多普勒超声对诊断脑实质出血性梗死、脑静脉血栓形成和脑动静脉畸形非常有帮助。脑实质内的颅内出血是由室管膜下静脉和终末静脉受压引起的,这会阻碍白质的静脉引流。基底节出血高度怀疑是脑静脉血栓形成,尤其是深部静脉引流。仅一侧大脑内静脉闭塞会导致单侧出血,双侧大脑内静脉血栓形成以及大脑大静脉或直窦闭塞会导致基底节双侧出血、脑室出血和白质出血性梗死。最常见的脑动静脉畸形是大脑大静脉动静脉畸形。在超声检查中,可以显示第三脑室后方的搏动性囊性结构。彩色编码多普勒超声可显示囊肿的血管性质。多普勒超声可以显示供血动脉,最常见的是脉络膜后动脉以及直窦的静脉引流。

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