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颅内静脉血栓形成:诊断、随访、迟发性并发症及潜在误区的综述。

Cerebral Venous Thrombosis: Review of Diagnosis, Follow-Up, Late Complications and Potential Pitfalls.

机构信息

Department of Radiology, Neuroradiology Section, Pontificia Universidad Catolica de Chile, Santiago Region Metropolitana, Chile.

Department of Radiology, Neuroradiology Section, Pontificia Universidad Catolica de Chile, Santiago Region Metropolitana, Chile.

出版信息

Curr Probl Diagn Radiol. 2021 Sep-Oct;50(5):725-733. doi: 10.1067/j.cpradiol.2020.08.007. Epub 2020 Aug 27.

DOI:10.1067/j.cpradiol.2020.08.007
PMID:32950306
Abstract

Cerebral venous thrombosis is a less common but relevant cause of stroke in adults. The clinical manifestations are nonspecific leading frequently diagnostic delays, so imaging findings are is of vital importance. Conventional imaging modalities, namely computed tomography and magnetic resonance imaging (MRI), allow identification of the thrombus and parenchymal involvement due to venous congestion to a variable degree, but this entity may appears as a nonexpected finding in a nonvenographic study. computed tomography and MRI venographies allow noninvasive confirmation of the diagnosis and adequate characterization of the extent of the thrombus and acute complications, both of them being robust diagnostic techniques. MR venography also can be done without the use of contrast media, which is especially important in certain clinical situations. Cerebral venous thrombosis needs follow-up, and imaging plays a key role in detection of late complications of the disease, including dural arteriovenous fistulas and intracranial hypertension due to veno-occlusive disease. Knowledge of other diseases and conditions that may mimic a thrombus is needed to avoid wrong diagnosis. In this article, we conduct a pictorial comprehensive review of cerebral venous thrombosis, including also the technical aspects of different imaging modalities, diagnosis and acute complications, follow-up, late complications and potential imaging mimics.

摘要

脑静脉血栓形成是成人中风中一种较少见但相关的病因。其临床表现缺乏特异性,导致诊断时常出现延误,因此影像学表现至关重要。传统的成像方式,即计算机断层扫描(CT)和磁共振成像(MRI),可以识别血栓和静脉充血引起的不同程度的实质受累,但在非血管造影研究中,可能会出现意想不到的静脉血栓形成表现。CT 和 MRI 静脉造影可以无创性地确认诊断,并充分描述血栓的范围和急性并发症,这两种方法都是强大的诊断技术。MR 静脉造影也可以在不使用造影剂的情况下进行,这在某些临床情况下尤为重要。脑静脉血栓形成需要随访,影像学在检测疾病的晚期并发症方面发挥着关键作用,包括硬脑膜动静脉瘘和静脉闭塞性疾病引起的颅内高压。为了避免误诊,需要了解可能模拟血栓的其他疾病和病症。本文对脑静脉血栓形成进行了全面的影像学综述,包括不同成像方式的技术方面、诊断和急性并发症、随访、晚期并发症和潜在的影像学模拟。

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