CAJ | 학술논문

目的：分析大脑皮质静脉血栓（CoVT）的临床表现、影像及病理学特点。方法回顾性收集海军总医院2006年1月-2013年6月收治的10例CoVT患者（4例单纯皮质静脉血栓，6例伴有静脉窦血栓），分析其病因、影像及3例脑组织病理检查的特点。结果10例CoVT患者，女3例，男7例，平均年龄（31±15）岁。（1）头部CT及MRI多提示为出血性梗死，增强MRI显示病灶多散在不均匀强化。DSA可发现不同部位皮质静脉血栓。（2）3例因首诊考虑占位性病变，行脑组织活检术。病理学检查见胶质细胞增生，血管内皮增生，伴吞噬细胞反应，并可见散在灶状出血，小静脉扩张显著，少数有血液淤滞或血栓形成。结论 CoVT是颅内静脉系统血栓的一种，多见于中青年，多为颅内静脉窦血栓形成，血栓逆行累及皮质静脉所致，易误诊为肿瘤占位，诊断需注意临床与影像学结合。
목적：분석대뇌피질정맥혈전（CoVT）적림상표현、영상급병이학특점。방법회고성수집해군총의원2006년1월-2013년6월수치적10례CoVT환자（4례단순피질정맥혈전，6례반유정맥두혈전），분석기병인、영상급3례뇌조직병리검사적특점。결과10례CoVT환자，녀3례，남7례，평균년령（31±15）세。（1）두부CT급MRI다제시위출혈성경사，증강MRI현시병조다산재불균균강화。DSA가발현불동부위피질정맥혈전。（2）3례인수진고필점위성병변，행뇌조직활검술。병이학검사견효질세포증생，혈관내피증생，반탄서세포반응，병가견산재조상출혈，소정맥확장현저，소수유혈액어체혹혈전형성。결론 CoVT시로내정맥계통혈전적일충，다견우중청년，다위로내정맥두혈전형성，혈전역행루급피질정맥소치，역오진위종류점위，진단수주의림상여영상학결합。
Objective To analyze the clinical,imaging and pathological features of cortical vein thrombosis (CoVT). Methods Ten patients with CoVT (4 patients with CoVT alone and 6 patients with CoVT and venous sinus thrombosis)treated at Navy General Hospital from January 2006 to Jun 2013 were collected retrospectively.Its etiology,imaging,and pathological features of brain tissue in 3 patients were analyzed. Results Of the 10 patients with CoVT,3 were female and 7 were male.Their mean age was 31 ± 15 years old.(1)Brain CT scan and MRI showed hemorrhagic cerebral infarction,and contrast-enhanced MRI showed scattered heterogeneous enhancement within lesions. DSA could find CoVT at different parts.(2)3 patients underwent brain biopsy because they were initially diagnosed as brain tumor. Pathological examination showed glial cell,endothelial proliferation and phagocytic reaction.Scattered spotty bleeding was observed,and significant expansion of small veins,A few of them had blood stasis and thrombosis. Conclusion CoVT is one kind of intracranial venous thrombosis. It is more common occurred in young and middle aged adults,and most of them were venous sinus thrombosis.It is caused by retrograde thrombosis and spread to cortical veins.CoVT is easily to be misdiagnosed as brain tumor.Combination of clinical and imaging findings is needed for accurate diagnosis.