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目的 探讨脑静脉 (窦 )血栓 (CVT)的临床特征和磁共振 (MR)特点。方法 回顾分析 1 2例经MR检查确诊的CVT患者的临床表现和影响学特征。结果 1 2例患者的阳性体征包括头痛 (1 0例 )、视乳头水肿 (8例 )等颅内压增高的征象 ,部分病例有局灶性神经功能异常如肢体瘫痪 (4例 )、外展神经麻痹 (2例 )、癫痫发作 (2例 )、昏迷 (2例 )及脑膜刺激征 (6例 )。常规Se序列T1 、T2 相示窦内高信号 ,脑实质水肿或合并出血、梗死。磁共振静脉血管成像 (MRV)能直接显示静脉窦闭塞及血栓栓子。CT检查显示 2例呈弥漫性脑水肿 ,3例脑叶见条索状高密度影 ,2例示顶叶出血 ,1例蛛网膜下腔出血。经降颅压、抗凝、溶栓、消炎及激素治疗均治愈。结论 MRI/MRV在诊断和随诊静脉窦血栓方面明显优于CT ,且抗凝、溶栓、降颅压、消炎是治疗静脉窦血栓的有效方法之一。
Objective To investigate the clinical features and magnetic resonance (MR) features of cerebral venous (sinus) thrombosis (CVT). Methods Retrospective analysis of 12 cases of patients with CVT confirmed by MR examination of clinical manifestations and impact characteristics. Results The positive signs of 12 patients included headache (10 cases) and papilledema (8 cases). Some cases had focal neurological dysfunction such as limb paralysis (4 cases), abduction Nerve paralysis (2 cases), seizure (2 cases), coma (2 cases) and meningeal irritation (6 cases). Conventional Se sequences T1 and T2 show sinusoidal hyperintensities, parenchymal edema or combined hemorrhage and infarction. Magnetic resonance venous angiography (MRV) can directly show sinus occlusion and thromboembolism. CT examination showed diffuse cerebral edema in 2 cases, cochlear high density in 3 cases, parotid hemorrhage in 2 cases and subarachnoid hemorrhage in 1 case. By reducing intracranial pressure, anticoagulation, thrombolysis, anti-inflammatory and hormone therapy were cured. Conclusion MRI / MRV is superior to CT in the diagnosis and follow-up of sinus thrombosis. Anticoagulation, thrombolysis, intracranial pressure reduction and anti-inflammatory are two effective methods for the treatment of venous sinus thrombosis.