疑难病杂志
疑難病雜誌
의난병잡지
JOURNAL OF DIFFICULT AND COMPLICATED CASES
2015年
2期
121-124
,共4页
李志方%孙彬彬%薛伟宁%张乐石%刘力学%周幼萍%樊双义
李誌方%孫彬彬%薛偉寧%張樂石%劉力學%週幼萍%樊雙義
리지방%손빈빈%설위저%장악석%류역학%주유평%번쌍의
颅内静脉窦血栓形成%诊断%影像学特点
顱內靜脈竇血栓形成%診斷%影像學特點
로내정맥두혈전형성%진단%영상학특점
Cerebral venous sinus thrombosis%Diagnosis%Imaging characteristics
目的:探讨颅内静脉窦血栓形成( CVST)的临床与影像学特点。方法回顾性分析9例CVST患者的临床、影像学资料。结果9例患者的男女比例为1∶1.25,平均发病年龄(46.7±14.9)岁;主要诱因为恶性肿瘤;临床主要表现为头痛、头晕、视物模糊、失语、肢体无力、癫痫发作等症状,可孤立或联合出现。仅有2例患者的头颅CT平扫显示病变静脉窦内高密度及条索征等直接征象。7例患者的头颅MR显示病变静脉窦内流空信号消失,随时相不同呈现不同信号影,增强扫描示“δ”征。8例患者的头颅MRV均有不同程度的静脉窦病变,表现为受累静脉窦狭窄或闭塞。经低分子肝素抗凝、脱水降颅压等治疗后,全部患者临床症状基本消失。结论 CVST临床表现复杂多样,缺乏特异性。头颅MR+MRV检查是诊断的主要手段,抗凝及脱水降颅压具有良好的治疗效果。
目的:探討顱內靜脈竇血栓形成( CVST)的臨床與影像學特點。方法迴顧性分析9例CVST患者的臨床、影像學資料。結果9例患者的男女比例為1∶1.25,平均髮病年齡(46.7±14.9)歲;主要誘因為噁性腫瘤;臨床主要錶現為頭痛、頭暈、視物模糊、失語、肢體無力、癲癇髮作等癥狀,可孤立或聯閤齣現。僅有2例患者的頭顱CT平掃顯示病變靜脈竇內高密度及條索徵等直接徵象。7例患者的頭顱MR顯示病變靜脈竇內流空信號消失,隨時相不同呈現不同信號影,增彊掃描示“δ”徵。8例患者的頭顱MRV均有不同程度的靜脈竇病變,錶現為受纍靜脈竇狹窄或閉塞。經低分子肝素抗凝、脫水降顱壓等治療後,全部患者臨床癥狀基本消失。結論 CVST臨床錶現複雜多樣,缺乏特異性。頭顱MR+MRV檢查是診斷的主要手段,抗凝及脫水降顱壓具有良好的治療效果。
목적:탐토로내정맥두혈전형성( CVST)적림상여영상학특점。방법회고성분석9례CVST환자적림상、영상학자료。결과9례환자적남녀비례위1∶1.25,평균발병년령(46.7±14.9)세;주요유인위악성종류;림상주요표현위두통、두훈、시물모호、실어、지체무력、전간발작등증상,가고립혹연합출현。부유2례환자적두로CT평소현시병변정맥두내고밀도급조색정등직접정상。7례환자적두로MR현시병변정맥두내류공신호소실,수시상불동정현불동신호영,증강소묘시“δ”정。8례환자적두로MRV균유불동정도적정맥두병변,표현위수루정맥두협착혹폐새。경저분자간소항응、탈수강로압등치료후,전부환자림상증상기본소실。결론 CVST림상표현복잡다양,결핍특이성。두로MR+MRV검사시진단적주요수단,항응급탈수강로압구유량호적치료효과。
Objective To investigate the clinical and imaging characteristics of cerebral venous sinus thrombosis ( CVST) . Methods Retrospectively analyzed 9 cases of CVST patients’ clinical and imaging data. Results 9 patients’ male to female ratio was 1∶1. 25, the average age was (46. 7 ± 14. 9) years; the main causes was malignant tumors; the clinical manifestations were headache, dizziness, blurred vision, aphasia, limb weakness, seizures and other symptoms, which can be isolated or the combination of all symptoms. Only 2 cases of patients’ cranial CT scan showed the lesions of sinus high density and strip signs. 7 cases’ MR showed venous sinus’ flow void signal disappeared, different signal intensity revealed along with the different phase, enhanced scan showed “delta" sign. MRV of these 8 patients had different degree of venous sinus le-sions, showing venous sinus stenosis or occlusion. The low molecular heparin anticoagulation and lowering the intracranial pressure after treatment, all the patients’ clinical symptoms disappeared. Conclusion The clinical manifestation of CVST is complicated and lack of specificity. The head MR+MRV examination is a major diagnostic method. Anticoagulation and low-ering the intracranial pressure has good curative effect.