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[皮质静脉血栓形成和脑静脉窦血栓形成的CT与MRI表现]

[CT and MRI Findings of Cortical Venous Thrombosis and Cerebral Venous Sinus Thrombosis].

作者信息

Akioka Naoki

机构信息

Department of Neurosurgery, Faculty of Medicine, University of Toyama.

出版信息

No Shinkei Geka. 2021 Mar;49(2):252-261. doi: 10.11477/mf.1436204386.

Abstract

The author reports the cases of two young patients with cortical venous thrombosis(CVT)and cerebral venous sinus thrombosis(CVST)and demonstrates that CT and MRI investigations are critical for the diagnosis. The first case was an 18-year-old woman who developed symptoms of intracranial hypertension and, 20 days later, suffered from left hemiparesis and generalized seizures. A plain CT scan revealed an increased density of cortical veins("cord sign"). MR venography revealed superior sagittal sinus thrombosis and right frontal lobe cortical vein thrombosis. The second case was a 15-year-old boy who developed intracranial hypertension symptoms and went to various hospitals but the symptoms progressed. Six weeks after the onset, contrast-enhanced MRI showed an "empty delta sign" and superior sagittal sinus thrombosis was diagnosed. The patients had a history of protein-losing enteropathy and Behçet's disease. Both patients were treated with endovascular and anticoagulation therapy while also treating the primary disease, resulting in thrombus reduction in the sinus and good outcomes. CVT and CVST can lead to severe conditions, so a full understanding of the imaging findings is essential for an accurate diagnosis.

摘要

作者报告了两例患有皮质静脉血栓形成(CVT)和脑静脉窦血栓形成(CVST)的年轻患者的病例,并表明CT和MRI检查对诊断至关重要。第一例是一名18岁女性,出现颅内高压症状,20天后出现左侧偏瘫和全身性癫痫发作。平扫CT显示皮质静脉密度增加(“索条征”)。磁共振静脉血管造影显示上矢状窦血栓形成和右侧额叶皮质静脉血栓形成。第二例是一名15岁男孩,出现颅内高压症状,辗转多家医院但症状仍进展。发病六周后,增强MRI显示“空三角征”,诊断为上矢状窦血栓形成。患者有蛋白丢失性肠病和白塞病病史。两名患者均接受了血管内治疗和抗凝治疗,同时治疗原发疾病,导致窦内血栓减少,预后良好。CVT和CVST可导致严重病情,因此全面了解影像学表现对于准确诊断至关重要。

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