摘要:
目的:探讨静脉脑栓塞患者的发病原因、临床表现及CT、磁共振成像(MRI)的影像表现。方法:回顾性分析8例(12处病灶)经临床及影像学联合检查确诊的静脉性脑栓塞患者临床资料。其中6例接受MRI增强扫描,部分患者接受外科手术治疗。分析其治疗前后CT平扫及MRI序列检查结果,评估其影像表现。结果:8例确诊患者中浅表型静脉性栓塞6例(单侧5例、双侧1例),临床表现为头痛、恶心、呕吐、局灶性神经功能缺损或癫痫发作;深部中央型静脉性栓塞者2例(单侧/双侧基底节丘脑静脉梗死各1例),临床表现均较轻且病情进展缓慢,预后效果较理想。12处病灶CT平扫均呈低密度影;T1WI图像呈低信号,DWI图像则呈高信号,T2WI图像呈高信号9处,混杂信号3处;6例行MRI增强扫8处病灶强化环厚薄均匀,但形态欠规则。结论:MRI相较于CT检查,能帮助医师更直观、清晰地了解静脉脑栓塞患者的病灶信息,对针对性治疗方案的拟定和预后效果的准确评估具有积极影响。
Abstract:
Objective: To investigate the pathogenesis, clinical manifestations, CT and magnetic resonance imaging(MRI) findings of patients with venous cerebral embolism. Methods: The clinical data of 8 patients(12 lesions) diagnosed by clinical and imaging combined examination was retrospectively analyzed. Among them, 6 patients underwent MRI enhanced scan and some patients underwent surgical treatment. The results of CT scan and MRI sequence examination were analyzed before and after treatment, and their imaging findings were evaluated. Results: Among the 8 diagnosed patients, 6 cases were diagnosed with superficial venous thrombosis(5 cases were unilateral and 1 case was bilateral). The clinical manifestations were headache, nausea, vomiting, focal neurological deficits or seizures; there were 2 cases with deep central venous thrombosis(unilateral/bilateral thalamus venous infarction in basal ganglia in 1 case respectively). The clinical manifestations were mild and the progression of pathogenic condition was slow. The prognosis was ideal. CT plain scan of 12 lesions showed low density shadow; T1 WI image showed low signal while DWI image showed high signal. T2 WI image showed high signal in 9 and mixed signal in 3; The 8 lesions in 6 cases undergoing enhanced MRI scan showed enhanced ring and thickness was homogeneous, irregular. Conclusions: Compared with CT examination, MRI can help doctors to understand the information of lesions in patients with venous cerebral embolism more directly and clearly, which has positive effect on the development of targeted therapy and the accurate assessment of prognosis.
百度学术
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