Furuya Sho, Kawabori Masahito, Fujima Noriyuki, Tokairin Kikutaro, Goto Shuho, Iwasaki Motoyuki, Niiya Yoshimasa, Mabuchi Shoji
Department of Neurosurgery, Otaru General Hospital.
Department of Neurosurgery, Hokkaido University Graduate School of Medicine.
Neurol Med Chir (Tokyo). 2017 Oct 15;57(10):557-561. doi: 10.2176/nmc.cr.2017-0033. Epub 2017 Aug 23.
We report two cases of cerebral venous thrombosis (CVT) which serial arterial spin labeling (ASL) was useful in evaluating the clinical course of the disease. A 48-year-old female presented with acute seizure, and was diagnosed as transverse-sigmoid sinus thrombosis. ASL imaging revealed low signal intensity in the right temporal lobe, suggesting the decreased perfusion by elevated venous pressure. Soon after the treatment, while the development of venous collateral has not fully observed by magnetic resonance (MR) angiography, low ASL signal within the right temporal lobe have shown remarkable improvement. A 65-year-old female presented with vomiting and subsequent seizure was diagnosed as superior sagittal sinus thrombosis. The low ASL signal within the right frontal lobe seen in the acute stage improved to the normal level by the course of time, before the good collateral can be seen by MR angiography. This is the first report to assess the sequential change of the cerebral perfusion of CVT by ASL, and ASL may provide additional useful information in combination with conventional modalities.
我们报告了两例脑静脉血栓形成（CVT）病例，其中连续动脉自旋标记（ASL）有助于评估该疾病的临床病程。一名48岁女性出现急性癫痫发作，被诊断为横窦-乙状窦血栓形成。ASL成像显示右侧颞叶低信号强度，提示静脉压升高导致灌注减少。治疗后不久，虽然磁共振（MR）血管造影未充分观察到静脉侧支循环的形成，但右侧颞叶内的低ASL信号已显示出显著改善。一名65岁女性出现呕吐，随后癫痫发作，被诊断为上矢状窦血栓形成。在急性期可见的右侧额叶低ASL信号随时间推移改善至正常水平，此时MR血管造影才可见良好的侧支循环。这是首次通过ASL评估CVT脑灌注的序列变化的报告，并且ASL可能与传统检查方法相结合提供额外的有用信息。
