CAJ | 학술논문

目的：探讨三维磁共振静脉成像（MRV）与DSA在颅内静脉窦血栓形成（CVST）诊断中的价值。方法回顾性纳入2008年1月-2014年2月第三军医大学第一附属医院（西南医院）住院的CVST患者29例。其中男11例，女18例。病程3 d至3个月，急性期（＜1周）9例，亚急性期（1～2周）12例，慢性期（＞2周）8例。所有患者均行MR（T1加权像、T2加权像）、三维MR静脉成像（MRV）及DSA检查。结果 DSA检出29例，MRV检出24例。与DSA比较，MRV阳性检出率为82．8％。有3例病变部位累及横窦及2例累及下矢状窦的患者未被MRV检出。MRI显示脑梗死12例，梗死性脑出血7例。T2加权序列上，16例显示静脉窦的流空效应消失，静脉窦内可显示出不同信号的血栓形成。MRV显示静脉部分显影的有14例，不显影的有10例，其中4例有侧支循环形成。结论与DSA比较，MRV诊断CVST存在一定的漏诊率，在临床工作中，MRV诊断为阴性，仍然不能排除CVST的诊断，需进一步行DSA检查。
목적：탐토삼유자공진정맥성상（MRV）여DSA재로내정맥두혈전형성（CVST）진단중적개치。방법회고성납입2008년1월-2014년2월제삼군의대학제일부속의원（서남의원）주원적CVST환자29례。기중남11례，녀18례。병정3 d지3개월，급성기（＜1주）9례，아급성기（1～2주）12례，만성기（＞2주）8례。소유환자균행MR（T1가권상、T2가권상）、삼유MR정맥성상（MRV）급DSA검사。결과 DSA검출29례，MRV검출24례。여DSA비교，MRV양성검출솔위82．8％。유3례병변부위루급횡두급2례루급하시상두적환자미피MRV검출。MRI현시뇌경사12례，경사성뇌출혈7례。T2가권서렬상，16례현시정맥두적류공효응소실，정맥두내가현시출불동신호적혈전형성。MRV현시정맥부분현영적유14례，불현영적유10례，기중4례유측지순배형성。결론여DSA비교，MRV진단CVST존재일정적루진솔，재림상공작중，MRV진단위음성，잉연불능배제CVST적진단，수진일보행DSA검사。
Objective To investigate the diagnostic value of three-dimensional magnetic resonance imaging (MRV ) and digital subtraction arteriography (DSA ) in cerebral venous sinus thrombosis (CVST). Methods Twenty-nine patients with CVST admitted to the First Affiliated Hospital of the Third Military Medical University (Southwest Hospital)from January 2008 to February 2014 were enrolled retrospectively. Eleven of them were males and 18 were females. Their course of disease ranged from 3 days to 3 months. Nine patients were in the acute phase (<1 week),12 were in the subacute phase (1-2 weeks),and 8 were in the chronic phase (>2 weeks). All the patients were underwent magnetic resonance (MR)(T1 or T2 weighted image ),three-dimensional MRV,and DSA examinations. Results DSA detected 29 and MRV detected 24 patients. MRI revealed 12 patients had cerebral infarction and 7 had cerebral infarct and hemorrhage. On T2-weighted sequences,16 patients showed the flow void effect of venous sinus disappeared,and thromboses with different signals in the sinuses. MRV showed part development of the veins in 14 cases and no development in 10 cases,including 4 with collateral circulation. Compared with DSA,the positive detection rate of MRV was 82. 8%. The lesion sites of 3 patients involving the transverse sinus and 2 involving the sagittal sinus were not detected on MRV. Conclusion Compared with DSA,the MRV has a certain percentage of missed diagnosis rate for CVST. In clinical work,if MRV diagnosis is negative,it can not exclude the diagnosis of CVST,and further DSA examination is needed.