CAJ | 학술논문

目的：探讨MSCT静脉成像（MSCTV）在诊断脑静脉窦血栓中的价值，以期为临床诊断脑静脉窦血栓提供一种更加简单、可靠的检查手段。方法对32例脑静脉窦血栓形成的患者进行38次M SC T双期血管成像（复查6例），即动脉期及静脉期（CTA＋CTV），由3位影像科高年资医师对图像进行独立分析，综合一致的意见作为诊断结果，以MRI＋MRV和/或DSA结果结合临床最终诊断作为判断诊断准确性的标准。结果横断面增强扫描清晰显示受累的静脉窦内无对比剂充填，窦壁较明显强化，上矢状窦及乙状窦表现为典型的三角形充盈缺损区，即空三角征，横窦及直窦血栓表现为带状充盈缺损区，冠状及矢状位MPR可以很清晰显示病灶。MSCTV图像更能直观地显示窦内充盈缺损区，与MRV或DSA图像完全一致，扩张的脑表面静脉MSCTV也能很好显示，同时可显示脑实质内的静脉性脑水肿和静脉性脑梗死及伴随的出血灶。结论 MSCTV可以清晰显示脑静脉窦血栓的影像特征，且较DSA及M RV简单、易行，可作为临床上可疑病例可靠的影像学检查手段。
목적：탐토MSCT정맥성상（MSCTV）재진단뇌정맥두혈전중적개치，이기위림상진단뇌정맥두혈전제공일충경가간단、가고적검사수단。방법대32례뇌정맥두혈전형성적환자진행38차M SC T쌍기혈관성상（복사6례），즉동맥기급정맥기（CTA＋CTV），유3위영상과고년자의사대도상진행독립분석，종합일치적의견작위진단결과，이MRI＋MRV화/혹DSA결과결합림상최종진단작위판단진단준학성적표준。결과횡단면증강소묘청석현시수루적정맥두내무대비제충전，두벽교명현강화，상시상두급을상두표현위전형적삼각형충영결손구，즉공삼각정，횡두급직두혈전표현위대상충영결손구，관상급시상위MPR가이흔청석현시병조。MSCTV도상경능직관지현시두내충영결손구，여MRV혹DSA도상완전일치，확장적뇌표면정맥MSCTV야능흔호현시，동시가현시뇌실질내적정맥성뇌수종화정맥성뇌경사급반수적출혈조。결론 MSCTV가이청석현시뇌정맥두혈전적영상특정，차교DSA급M RV간단、역행，가작위림상상가의병례가고적영상학검사수단。
Objective To evaluate the value of MSCTV in the diagnosis of cerebral venous sinus thrombosis(CVST ) ,in an attempt to provide a simple but more effective imaging method in the evaluation of cerebral venous sinus thrombosis clinically . Methods 32 patients with cerebral venous sinus thrombo-sis underwent biphasic contrast-enhanced CT scan (i .e .arterial and venous phases or CTA+CTV) using a MSCT scanner (follow-up CT in 6 cases) ,with a total of 38 MSCT examination being performed . The data were independently analyzed by three experienced radiologists and CT-based diagnosis was made when there is a consensus among the three radiologists . T he criteria of diagnostic accuracy ,based on the re-sults of MRI+ MRV and/or DSA correlating with clinilal diagnosis ,was used . Results Filling defect was seen within the involved venous sinuses on axial contrast-enhanced CT images and moderate enhance-ment of the sinal wall was significantly observed . Triangular area of filling defects is the typical feature of superior sagittal sinus and sigmoid sinus thrombosis , w hich termed as "empty triangle sign", and thrombosis in the transverse and straight sinuses manifested as girdle-shaped filling defect ,which was clearly revealed on coronal and sagittal MPR . MSCTV is capable of demonstrating filling defect within sinus ,competing with MRV or DSA . MSCTV possess ,to a considerable degree ,the ability to depict the dilated superficial cerebral veins ,as well as the cerebral venous edema and/or infarction with or without hemorrhage . Conclusion MSCTV can clearly display the image characteristics of CVST . Compared to MRV or DSA ,it is simple and feasible and becoming a reliable imaging method for screening patients with suspected CVST .