Bell D A, Davis W L, Osborn A G, Harnsberger H R
Department of Radiology, University of Utah School of Medicine, Salt Lake City.
AJNR Am J Neuroradiol. 1994 May;15(5):893-9.
To determine whether MR angiography can be used to differentiate between the two vascular causes of bithalamic hyperintensity on T2-weighted MR images: "top of the basilar" artery occlusion and deep cerebral vein thrombosis.
A retrospective review identified six patients with bithalamic T2 hyperintensity of vascular causes. MR angiography was performed in four patients, MR angiography and conventional angiography in one patient, and conventional angiography in one patient. Data pertaining to clinical presentation and hospital course were collected. MR angiographic techniques were multislab overlapping three-dimensional time-of-flight, 2-D time-of-flight, and 2-D phase-contrast.
Three cases of top of the basilar artery occlusion and three cases of deep cerebral vein thrombosis were recognized. In all cases, T2 hyperintensity in a vascular distribution suggested cerebral occlusive disease. Infarction involving the thalami and basal ganglia was present in two cases of deep cerebral vein thrombosis. Infarction of the thalami, mesodiencephalic region, and cerebellar hemispheres was present in two cases of basilar artery occlusion. Bithalamic infarction alone was seen in one case of deep cerebral vein thrombosis and one case of basilar artery occlusion. In the five cases in which MR angiography was used, this technique accurately distinguished the vessels involved (arterial or venous).
MR angiography is a useful adjunct to MR imaging in the evaluation of bithalamic T2 hyperintensity. It does help distinguish between the two vascular causes: top of basilar artery occlusion and deep cerebral vein thrombosis.
确定磁共振血管造影（MR angiography）是否可用于鉴别T2加权磁共振图像上双侧丘脑高信号的两种血管性病因：基底动脉尖闭塞和大脑深静脉血栓形成。
一项回顾性研究纳入了6例因血管性病因导致双侧丘脑T2高信号的患者。4例患者接受了磁共振血管造影检查，1例患者接受了磁共振血管造影和传统血管造影检查，1例患者仅接受了传统血管造影检查。收集了有关临床表现和住院病程的数据。磁共振血管造影技术包括多层面重叠三维时间飞跃法、二维时间飞跃法和二维相位对比法。
共识别出3例基底动脉尖闭塞和3例大脑深静脉血栓形成。在所有病例中，血管分布区域的T2高信号提示脑闭塞性疾病。2例大脑深静脉血栓形成患者出现累及丘脑和基底节的梗死。2例基底动脉闭塞患者出现丘脑、中脑间脑区域和小脑半球梗死。1例大脑深静脉血栓形成和1例基底动脉闭塞患者仅出现双侧丘脑梗死。在使用磁共振血管造影的5例患者中，该技术准确区分了受累血管（动脉或静脉）。
在评估双侧丘脑T2高信号时，磁共振血管造影是磁共振成像的有用辅助手段。它确实有助于区分两种血管性病因：基底动脉尖闭塞和大脑深静脉血栓形成。
