MR Imaging Features of Isolated Cortical Vein Thrombosis: Diagnosis and Follow-Up
MR Imaging Features of Isolated Cortical Vein Thrombosis: Diagnosis and Follow-Up
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DOI：
10.3174/ajnr.a1332
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发表时间：
2009-02-01
影响因子：
3.5
通讯作者：
Chabriat, H.
中科院分区：
文献类型：
--
作者：
Boukobza, M.;Crassard, I.;Chabriat, H.
背景和目的：据我们所知，孤立性皮质静脉血栓形成（ICoVT）的MR成像数据很少报道。本研究的目的是描述MR成像特征，包括T2* 梯度回波（GE）序列，在假定的ICoVT。材料和方法：对8例ICoVT患者进行了MRI检查所有患者均行MR静脉造影，4例行数字减影血管造影（4例患者）和3个月（8例患者）、6个月（6例患者）、12个月（3例患者）和18个月（1例患者）。我们评估了每个脑静脉血栓形成部位T2*GE成像上是否存在磁化率效应（MSE），以及T1、T2、弥散加权成像（DWI）和液体衰减反转恢复（FLAIR）图像上是否存在正常血流空泡和等、低或高信号强度。实质信号强度的变化也进行了评估，在相同的sequences.RESULTS：MSE检测T2*GE成像在所有受试者在第一次MR成像检查的皮质静脉的网站。3例患者闭塞静脉在T1上呈高信号，1例呈等至稍高信号，6例在FLAIR图像上呈低信号，3例在DWI上呈信号强度损失。随访时，所有患者的静脉部位均检测到T2*GE成像上持续的信号强度异常，而T1和T2加权图像上的信号强度变化不再存在。在6/8例患者的血栓附近观察到FLAIR和DWI上的实质高信号（表观扩散系数[ADC]增加）。5/8例患者在T2*GE成像上存在瘀点（n = 3）或血肿（n = 2）。随访期间，T1、T2和FLAIR图像上所有脑组织信号强度变化的体积和强度均降低。ADC值正常化的组织内3个月后，在所有patients.CONCLUSIONS：T2*GE成像，MSE的血红蛋白产品内的血栓观察到在早期和晚期阶段的ICoVT，似乎是高诊断价值相比，其他信号强度的变化检测标准的MR成像。
BACKGROUND AND PURPOSE: To our knowledge, very few MR imaging data have been reported in isolated cortical venous thrombosis (ICoVT). The purpose of this study was to describe MR imaging features, including T2*gradient-echo (GE) sequence, in presumed ICoVT.MATERIALS AND METHODS: MR imaging examinations were performed in 8 patients with ICoVT (MR venography was performed in all patients and digital substraction angiography in 4) at the time of diagnosis and during the follow-up at 15 days (4 patients) and at 3 (8 patients), 6 (6 patients), 12 (3 patients), and 18 months (1 patient). We assessed the presence of a magnetic susceptibility effect (MSE) on T2*GE imaging at each site of cerebral venous thrombosis and the presence or absence of a normal flow void and iso-, hypo-, or hyperintense signal intensity on T1, T2, diffusion-weighted imaging (DWI), and fluid-attenuated inversion recovery (FLAIR) images. Parenchymal signal-intensity changes were also assessed on the same sequences.RESULTS: MSE was detected on T2*GE imaging at the site of a cortical vein in all subjects at the first MR imaging examination. The occluded vein appeared as hyperintense in 3 patients, iso- to slightly hyperintense in 1 on T1, hypointense in 6 on FLAIR images, and as signal-intensity loss on DWI in 3. At follow-up, persisting signal-intensity abnormalities on T2*GE imaging were detected at the venous sites in all patients, whereas signal-intensity changes on T1- and T2-weighted images were no longer present. Parenchymal hyperintensities on FLAIR and DWI (increased apparent diffusion coefficient [ADC]) were observed in close vicinity to the thrombosis in 6/8 patients. Petechial hemorrhages (n = 3) or hematoma (n = 2) was present on T2*GE imaging in 5/8 patients. During the follow-up, all cerebral tissue signal-intensity changes on T1, T2, and FLAIR images decreased both in volume and intensity. ADC values normalized within the tissue after 3 months in all patients.CONCLUSIONS: On T2*GE imaging, MSE of hemoglobin products within the thrombus was observed both at the early and late phases of ICoVT and appears to be of high diagnostic value compared with the other signal intensity changes detected on standard MR imaging.