颅内静脉窦血栓形成.docx

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1、颅内静脉窦血栓形成（cerebralvenoussinusthrombosis，CVST）颅内静脉窦血栓形成（cerebralvenoussinusthrombosis，CVST）•颅内静脉窦的血栓引起窦腔狭窄、闭塞、脑静脉血回流和脑脊液吸收障碍的一种疾病。分为炎性和非炎性两类。•静脉窦血栓形成是一种特殊类型的脑血管疾病，其病因多样，发病机制复杂．临床表现也无明显特异性，因此常被漏诊和误诊。本病如不能及时明确诊断和有效治疗，常具有较高的病死率，占成人中风的1～2％.•近年来随着磁共振成像(MRI)

2、的广泛使用，其发现率也在增加。该病多见于20岁～35岁女性。最常见于上矢状窦、横窦和乙状窦，其次为海绵窦和直窦.Figure3.AxialMRimageserieswithacoloroverlayrepresentsthemajorsuperficialcorticalvenousdrainageterritoriesaccordingtoMederetal(21).•Mostofthesuperiorcerebrum(green)isdrainedprimarilyintothesuperio

3、rsagittalsinus.•Thesylvianveinsdrainbloodfromtheperi-insularregion(yellow)intothebasalduralsinuses.•Thetransversesinusesreceivebloodfromthetemporal,parietal,andoccipitallobes(blue).LeachJLetal.Radiographics2006;26:S19-S41©2006byRadiologicalSocietyofNo

4、rthAmericaFigure5.AxialMRimagewithcoloroverlayshowsthedrainageterritoryofthedeepcerebralveins(internalcerebralvein,veinofGalen)(pink),inwhichparenchymalabnormalitiesduetodeepvenousocclusiontypicallyarefound.LeachJLetal.Radiographics2006;26:S19-S41©200

5、6byRadiologicalSocietyofNorthAmerica主要影像学特征CT直接征象条索.Pseudotumorcerebriina47-year-oldwomanwithelevatedcerebrospinalfluidpressuredocumentedatlumbarpuncture.LeachJLetal.Radiographics2006;26:S19-S41静脉窦血栓___出血性梗塞AxialCTimagesfromthreepatientswithsinusthrom

6、bosis.LeachJLetal.Radiographics2006;26:S19-S41MRI直接征象ABCSubacutethrombusofthesuperiorsagittalsinus.(a,b)AxialT1-weighted(a)andaxialT2-weighted(b)MRimagesshowanareaofabnormalincreasedsignalintensityinthesuperiorsagittalsinus(arrow).(c)Sagittalsourceima

7、gefromcontrast-enhancedMRvenographyshowsfillingdefects(arrows)duetoathrombus.Figure19.Occlusionoftheanteriorsuperiorsagittalsinus.LeachJLetal.Radiographics2006;26:S19-S41静脉窦血栓伴脑出血b.Thrombosisofthestraightsinus,veinofGalen,andinternalcerebralveins.Leac

8、hJLetal.Radiographics2006;26:S19-S41•T2*加权梯度回波（T2*-weightedgradient-echo，T2*GE）对CVST有更高的诊断价值，特别是单纯皮层静脉血栓。•在磁敏感效应的作用下，血栓在T2上呈现低信号，与颅内出血的信号相似.BoukobzaM,etal..AJNRAmJNeuroradiol.2009;30(2):344-348.Superiorsagittalsinusthrombosisandparenchymalchan