摘要
目的：分析脑静脉窦/脑静脉血栓形成（CVST/CVT）CT平扫的影像学表现特征，以便提高CT平扫对CVST/CVT的早期认识，优化诊断方法，减少误诊。材料与方法：搜集拟诊为CVST/CVT病例25例的平扫及部分增强病例，经与MR与DSA等对照。重点回顾会诊前后血栓本身的CT平扫的直接征象及间接征象并进行对照，比较两者的结果。结果：CT平扫初诊血栓的直接征象的阳性率为13/25，阴性率为12/25，其中假阳性3例，假阴性8例。会诊后血栓阳性征象为21/25，阴性率为4/25，经统计学分析两者差别有显著性。而脑实质改变，会诊前检查的阳性率为20/25，阴性为5/20，而会诊后影像学阳性率为21/25，阴性为4/25，经统计学分析两者的差别无显著性。同时分析了CT平扫误诊原因及正确进行影像学检查的策略。结论：CVST/CVT CT初次平扫，大多都有血栓的直接征象及间接征象，正确认识这些征象，可以提示CVST/CVT的存在，并推荐立即行CTV检查来证实CT平扫的初步意见。
Abstract
Objective: To analyze the initial imaging of unenhanced CT(UECT) in cerebral venous sinus thrombosis/cerebral venous thrombosis(CVST/CVT), and to optimize imaging diagnostic approach in order to decrease misdiagnosis. Materials and Methods: To review the initial imaging findings of UECT in 25 suspicious patients with CVST/CVT retrospectively, and to compare with MR and DSA results. The results of CVST/CVT UECT direct sign and indirect sign of initial imaging were interpreted by local radiologist and were compared with the consultant results by experienced radiologist. Results: The initial positive imaging direct signs were 13/25, the negative imaging signs were 12/25, the pseudo-positive was 3/25, the pseudo-negative was 8/25. The positive direct signs of the consultant interpretation were 21/25, the negative direct signs were 4/25, the pseudo-positive was 3/25, the negative was 4/25. There were significant difference between the two groups. The UECT initial positive imaging indirect signs of parenchymal changes were 20/25, the negative imaging signs were 5/20, the positive direct sign after consultation was 3/25, the negative sign was 4/25. There were no significant difference between the two groups. The causes of misdiagnosis of UECT initial imaging study were analyzed, and we promoted an imaging diagnostic approach. Conclusion: UECT can be an initial valuable imaging study in CVST/CVT. It showed initial direct and indirect imaging signs in most cases. These signs should be correctly interpreted in the patients with suspicious CVST/CVT. When there are positive signs on the UECT, it can be immediately followed by CTV.
关键词
静脉血栓形成 /
体层摄影术 /
X线计算机
Key words
venous thrombosis /
tomography /
X-ray computed
邬美惠;王 娟;周义成.
脑静脉窦及脑静脉血栓CT平扫表现及影像学诊断策略[J]. 中国临床医学影像杂志. 2007, 18(10): 685-688
WU Mei-hui;WANG Juan;ZHOU Yi-cheng.
Initial imaging characteristics of unenhanced CT and imaging diagnostic approach in cerebral venous sinus thrombosis and cerebral venous thrombosis[J]. Journal of China Clinic Medical Imaging. 2007, 18(10): 685-688
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