颅内静脉窦血栓所致颅内出血CT影像特点分析VIP专享VIP免费

776ChineseJournalofPracticalInternalMedicineSeptember2015Vo1．35No．9论著颅内静脉窦血栓所致颅内出血CT影像特点分析杨雅文，李倩，吕斌，田成林DOI：10-75O4／nk2015080408中图分类号：R743．9文献标识码：A摘要：目的分析颅内静脉窦血栓形成所致颅内静脉性出血的CT影像特点。方法选取2006-2013年间解放军总医院神经内科收治的经经头颅磁共振成像(MRI)+全脑血管造影(DSA)或头颅静脉核磁共振成像(MRV)或头颅静脉电子计算机断层扫描(CTV)检查确诊的颅内静脉窦血栓形成患者，经头颅CT证实存在出血共24例，总结其出血在CT平扫影像的特点。结果出血部位除3例位于大脑凸面蛛网膜下腔外，其他均分布在脑叶。其中上矢状窦病变7例，其并发的出血主要位于额叶；侧窦病变7例，其并发出血部位主要位于同侧的颞叶及顶叶；多个静脉窦病变共10例，为上矢状窦合并一侧和(或)双侧侧窦病变，其并发出血可位于额、顶、颞及枕叶。就出血形态而言，渗血、点片状出血共13例，类似动脉性出血的实体血肿共3例，实体血肿合并渗血共5例，出血周围可合并与血肿体积不匹配的大面积低密度区，实体血肿其低密度区直径／出血直径=1．85(1．62～2．27)。结论颅内静脉窦血栓形成所致静脉性出血多见于脑叶，可多部位同时发生，多呈点片状渗血，较少形成实体血肿。关键词：颅内静脉窦血栓；颅内出血Imagingfeaturesonnon—contrastcomputedtomographyofintracranialhemorrhageresultingfromcerebralvenoussinusthrombosis．YANGYa—wen,LIOdan,LYUBin,TIANCheng-lin．DepartmentNeurology,ChinesePLAGeneralHospital,Bering10085~ChinaCorrespondingauthor：TIANCheng-lin,E—maihtianchenglin719@aliyun．cornAbstract：ObjectivesTostudytheiraangfeaturesonthenon-contrastcomputedtomography(CT)ofintracranialhemorrhageresultingfromcerebralvenoussinusthrombosis(CVT)．MethodsNeuroimagingdataof24patientswithCVTadmittedtoourdepartmentfrom2006to2013wereretrospectivelycoUected．CVTwasdemonstratedbyMRI+DSA／MRV／CTVinallthe24patients．Imngfeaturesonnon．contrastCTweresummarized．ResultsTwentyoneofthe24patientshadintracerebrallobehemorrhage，andtheother3patientshadconvexalsubarachnoidhemorrhage(cSAH)．In7caseswithisolatedthrombosedsuperiorsagittalsinus，hemorrhagewaslocatedinthefrontallobe．Whileanother7caseswithisolatedthrombosed1ateral，thehemorrhagewaslocatedintheipsilateralfrontallobeandparietallobe．Multiplethrombosesinvolvingthesuperiorsagitalsinuscombinedwiththeunilateralorbilaterallateralsinusweredetectedin10cases．Thefrontallobe,temporallobe,parietallobeandoccipitallobecouldbeallaflictedwiththevenoushemorrhageinthese10cases．Asfarasthepaternsofhemorrhagewereconcerned,homogeneousdense-hemorrhagesresemblingarterialhematomaweredetectedin3cases，while13casespresentedpetechialhemorrhages．Homogeneous‘densehematomaandpetechialhemorrhageexistedsimultaneouslyin5cases．Obviouslow-densityareawhichdidnotmatchthevolumeofhemorrhagewasacominonfindingJandtheratioofthediameterofperihematomalowdensityareatothediameterofdensehematomawas1．85(1．62．2．27)．ConclusionCVT-inducedhemorhagesaremostlylocatedinbrainlobe,andcSAHmayalsobefound．Keywords：cerebralvenoussinusthrombosis；intracranialhemorrhage颅内静脉和静脉窦血栓形成(cerebralvenoussinusthrombosis，CVT)是一种少见的脑血管疾病，占全部卒中的0．5％～1．0％_J。]。在CVT患者中近1／3的患者合并颅内出血[3]，认识CVT所致静脉性出血的影像特点有助于将其与动脉性出血区分开来，通过出血的表象及时发现潜在的CVT。现将我院作者单位：解放军总医院神经内科，北京100853通信作者：田成林，电子信箱：tiancheng1in719@aliyun．corn收治的24例患者影像特点总结如下。1材料与方法1．1一般资料所有患者来自2006-2013年解放军总医院神经内科...