弥散加权成像在脑静脉血栓形成诊断中的作用
Role of diffusion-weighted imaging in the diagnosis of cerebral venous thrombosis.
作者信息
Lv Bin, Tian Cheng-Lin, Cao Xiang-Yu, Liu Xin-Feng, Wang Jun, Yu Sheng-Yuan
机构信息
Department of Neurology, Chinese PLA General Hospital, Beijing, China.
出版信息
J Int Med Res. 2020 Jun;48(6):300060520933448. doi: 10.1177/0300060520933448.
OBJECTIVE
To evaluate the hyperintense signal (HIS) performance on diffusion-weighted imaging (DWI) in diagnosing cerebral venous thrombosis (CVT).
METHODS
Seventy-eight patients with CVT hospitalized from January 2004 to January 2015 were retrospectively studied alongside 78 controls without intracranial organic diseases. Diagnostic accuracy indices of HIS on DWI or T2-weighted imaging (T2WI) to diagnose CVT at different sites and states were analyzed.
RESULTS
The overall sensitivity of HIS on DWI for the diagnosis of CVT was significantly lower than that of HIS on T2WI (34.6% vs. 79.5%). HIS on T2WI was more sensitive than HIS on DWI in detecting thrombosis, especially in the superior sagittal sinus and transverse sinus. HIS on DWI was inversely related to the time between disease onset and imaging. Compared with HIS on T2WI, combining HIS on DWI and T2WI did not increase the sensitivity for detecting CVT. HIS on DWI was not detected in the control group, but HIS on T2WI was detected in 26.3% of control individuals. The specificity of HIS on DWI for CVT was higher than that of HIS on T2WI (97.4% vs. 76.9%).
CONCLUSION
HIS on DWI has a lower sensitivity, but a higher specificity, than HIS on T2WI for diagnosing CVT.
目的
评估扩散加权成像（DWI）上的高信号（HIS）在诊断脑静脉血栓形成（CVT）中的表现。
方法
回顾性研究2004年1月至2015年1月期间住院的78例CVT患者，并与78例无颅内器质性疾病的对照者进行比较。分析DWI或T2加权成像（T2WI）上HIS对不同部位和状态的CVT进行诊断的准确性指标。
结果
DWI上HIS对CVT诊断的总体敏感性显著低于T2WI上的HIS（34.6%对79.5%）。T2WI上的HIS在检测血栓形成方面比DWI上的HIS更敏感，尤其是在上矢状窦和横窦。DWI上的HIS与疾病发作和成像之间的时间呈负相关。与T2WI上的HIS相比，联合DWI和T2WI上的HIS并没有提高检测CVT的敏感性。对照组未检测到DWI上的HIS，但26.3%的对照个体检测到T2WI上的HIS。DWI上HIS对CVT的特异性高于T2WI上的HIS（97.4%对76.9%）。
结论
对于诊断CVT，DWI上的HIS比T2WI上的HIS敏感性更低，但特异性更高。
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