医学精品课件：脑静脉窦血栓之诊断概要.pptx

1、脑静脉窦血栓之诊断概要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福建医科大学附属第一医院影像科郑郑 贤贤 应应 Causes of and Predisposing Factors for Cerebral Venous ThrombosisClinical Features of Cerebral Venous ThrombosisAcute stage(05 days)In the acute stage of thrombus formation,the signal is predominantly isointense on T1WI and hypointense on

2、T2WI because of deoxyhemoglobin in red blood cells trapped in the thrombus Subacute stage(615 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 t

3、hrombus is typically isointense or hyperintense on T2WI and isointense on T1WI Sinus enhancement is presumably secondary to an organized thrombus with intrinsic vascularization as well as to slow flow in dural and intrathrombus collateral channels主要主要CTCT征象征象正常静脉窦正常静脉窦CTCT值值？正常颅脑组织正常颅脑组织CT值值 脑灰质CT值3

4、4-39Hu 脑白质CT值26-29Hu 静脉窦CT值40-60Hu直接征像直接征像？束带征（索条征）束带征（索条征）高密度三角征高密度三角征直窦及大脑大静脉血栓直窦及大脑大静脉血栓深静脉血栓深静脉血栓:基底静脉基底静脉及直窦密度及直窦密度增高增高高密度血栓占高密度血栓占25%25%？双侧横窦及双侧横窦及右侧右侧乙状窦血栓乙状窦血栓？右侧横窦右侧横窦血栓血栓 充盈缺损充盈缺损Empty delta sign？Pseudo empty delta signArachnoid granulations间接征像间接征像静脉性梗死、水肿、静脉性出血静脉性梗死、水肿、静脉性出血 左左侧额顶叶静脉性侧额顶叶静脉性脑梗死伴脑梗死伴静脉性脑出血静脉性脑出血右侧额顶叶静脉性脑出血右侧额顶叶静脉性脑出血动脉性脑出血动脉性脑出血紫绀型心脏病（法洛氏四联症），高血红蛋白血症紫绀型心脏病（法洛氏四联症），高血红蛋白血症？总总 结结主要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谢谢 ！