脑静脉窦血栓之诊断概要PPT.pptx

脑静脉窦血栓之诊断概要福建医科大学附属第一医院影像科郑 贤 应 Causes of and Predisposing Factors for Cerebral Venous ThrombosisClinical Features of Cerebral Venous ThrombosisSubacute stage (6–15 days) In the subacute stage of thrombus development， the signal is predominantly hyperintense on both T1WI and T2WI because of methemoglobin in the thrombus Chronic stage (15-day-old)the signal in a chronic thrombus is typically isointense or hyperintense on T2WI and isointense on T1WISinus enhancement is presumably secondary to an organized thrombus with intrinsic vascularization as well as to slow flow in dural and intrathrombus collateral channels主要CT征象？正常静脉窦CT值正常颅脑组织CT值脑灰质CT值34-39Hu脑白质CT值26-29Hu静脉窦CT值40-60Hu直接征像？束带征（索条征）高密度三角征直窦及大脑大静脉血栓深静脉血栓: 基底静脉及直窦密度增高高密度血栓占25% ？？双侧横窦及右侧乙状窦血栓右侧横窦血栓充盈缺损Empty delta sign？Pseudo empty delta signArachnoid granulations间接征像静脉性梗死、水肿、静脉性出血 左侧额顶叶静脉性脑梗死伴静脉性脑出血右侧额顶叶静脉性脑出血动脉性脑出血？紫绀型心脏病（法洛氏四联症），高血红蛋白血症总 结主要CT征像直接征像：束带征（索条征）、高密度三角征； CTV见充盈缺损或空三角征间接征像：脑肿胀；脑水肿；静脉性脑梗塞；静脉性脑出血等。主要MRI征象流空影消失（T2WI）增强扫描：充盈缺损MRV 静脉或静脉窦不显影谢　谢 ！Increased attenuation in the venous sinuses also may be seen in patients with dehydration, an elevated hematocrit level, or a subjacent subarachnoid or subdural hemorrhage. a close comparison of sinus attenuation with arterial attenuation周围强化说明什么？ they are most commonly seen in the transverse and superior sagittal sinuses on anatomic images与邻近脑动脉比较