脑静脉窦血栓形成的磁共振成像及磁共振静脉血管造影变化模式

Pattern of magnetic resonance imaging and magnetic resonance venography changes in cerebral venous sinus thrombosis.

作者信息

Zafar A, Ali Z

机构信息

Department of Neurology, Government Lady Reading Hospital Peshawar, Pakistan.

出版信息

J Ayub Med Coll Abbottabad. 2012 Jan-Mar;24(1):63-7.

PMID:23855098

Abstract

BACKGROUND

Cerebral venous sinus thrombosis is a common but highly under-recognised condition, which is missed not only by general practitioners but also by neurologists. Computerised tomography (CT) or magnetic resonance imaging (MRI) of brain alone is not sufficient to diagnose this condition. Objective of this study was to explore the pattern of magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) changes in cerebral venous sinus thrombosis (CVST).

METHODS

This was a descriptive study in which 52 cases of cerebral venous sinus thrombosis with special emphasis on their MRI and MRV findings were included. The study was conducted in Neurology Unit, Lady Reading Hospital, Peshawar, Pakistan, from January 2010 to July 2011. All patients suffering from cerebral venous sinus thrombosis were included in the study. Multi-planar/multi-sequential, Tesla 1.5 MRI/MRV time of flight images were done in all cases where there was suspicion of cerebral venous sinus thrombosis.

RESULTS

Out of 52 patients with cerebral venous sinus thrombosis 41 (78.84%) were female and 11 (21.15%) were male. Mean age was 37 +/- 5 years. Definite risk factors were found in 38 (73.076%) patients with pregnancy, use of oral contraceptives or puerperium being the most frequently found risk factor in 20 (73.076%) patients. Most common complaint was headache found in 41 (78.84%) patients, followed by focal neurological deficits, and altered mental status and seizures. Papilloedema was seen in 20 (38.46%) patients. The cerebral venous sinuses most frequently involved were transverse and sigmoid sinuses in 17 patients (32.69%) while superior sagittal sinus alone in 10 (19.23%) patients. Overall CT brain was normal in 30% and MRI brain in 23.07% patients; however, MRV of these patients revealed CVST.

CONCLUSION

Imaging plays a primary role in the diagnosis of cerebral venous sinus thrombosis because the clinical picture of CVST is non-specific and highly variable. Thrombosis of cerebral venous system is readily picked-up on MRV even if it is missed by CT scan or MRI.

摘要

背景

脑静脉窦血栓形成是一种常见但极易被漏诊的疾病，不仅全科医生会漏诊，神经科医生也会漏诊。仅靠脑部计算机断层扫描（CT）或磁共振成像（MRI）不足以诊断此病。本研究的目的是探讨脑静脉窦血栓形成（CVST）的磁共振成像（MRI）和磁共振静脉血管造影（MRV）变化模式。

方法

这是一项描述性研究，纳入了52例脑静脉窦血栓形成病例，并特别关注其MRI和MRV表现。该研究于2010年1月至2011年7月在巴基斯坦白沙瓦的雷丁夫人医院神经科进行。所有脑静脉窦血栓形成患者均纳入研究。对所有疑似脑静脉窦血栓形成的病例均进行了多平面/多序列的1.5特斯拉MRI/MRV时间飞跃成像。

结果

52例脑静脉窦血栓形成患者中，41例（78.84%）为女性，11例（21.15%）为男性。平均年龄为37±5岁。38例（73.076%）患者发现了明确的危险因素，其中妊娠、使用口服避孕药或产褥期是最常见的危险因素，20例（73.076%）患者存在该危险因素。最常见的主诉是头痛，41例（78.84%）患者出现头痛，其次是局灶性神经功能缺损、精神状态改变和癫痫发作。20例（38.46%）患者出现视乳头水肿。最常受累的脑静脉窦是横窦和乙状窦，17例患者（32.69%）受累，仅上矢状窦受累的患者有10例（19.23%）。总体而言，30%的患者脑部CT正常，23.07%的患者脑部MRI正常；然而，这些患者的MRV显示存在CVST。