Department of Medical Imaging, Monash Children's Hospital, 246 Clayton Road, Clayton, Victoria 3168, Australia.
Pediatr Radiol. 2013 Jan;43(2):219-31. doi: 10.1007/s00247-012-2402-6. Epub 2012 Sep 5.
Paediatric cerebral sinovenous thrombosis (CSVT) is a rare but serious condition. The imaging signs may be subtle with a number of potential pitfalls. We present a pictorial essay of the pitfalls of diagnosis of CSVT on CT and MRI. We describe, using examples, potential pitfalls on both imaging modalities including anatomical variants of the cerebral venous system, extra-axial fluid collections and enhancement of chronic thrombus. Pitfalls particular to CT are discussed including beam-hardening artefact, image windowing and neonatal physiological intravascular hyperdensity. We review the potential variability in the appearance of thrombus on MRI, dependent largely on the stage of thrombus evolution and the pulse sequence. The signal intensity of thrombi, although described as evolving in a typical pattern on T1- and T2-weighted MRI, may be affected by variability in the degree of oxygenation of red cells in the forming thrombus, dilution and secondary propagation of thrombosis. Individual MRI sequences should not be interpreted in isolation, but as a set, and compared with CT images if available.
小儿脑静脉窦血栓形成（CSVT）是一种罕见但严重的疾病。其影像学征象可能不明显，存在多种潜在的陷阱。我们通过图片示例介绍了 CT 和 MRI 诊断 CSVT 的陷阱。我们描述了两种成像方式上的潜在陷阱，包括脑静脉系统的解剖变异、颅外积液和慢性血栓增强。还讨论了 CT 特有的一些陷阱，包括束硬化伪影、图像窗宽和新生儿生理性血管内高密度。我们回顾了 MRI 上血栓表现的潜在可变性，主要取决于血栓形成的阶段和脉冲序列。尽管血栓的信号强度在 T1 加权和 T2 加权 MRI 上描述为呈典型模式演变，但可能受到形成血栓中红细胞的氧合程度、稀释和血栓继发性传播的变化影响。不能孤立地解释个别 MRI 序列，而应作为一组进行解释，并与 CT 图像进行比较（如果有）。
