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颅内静脉血栓(cerebral venous sinus thrombosis,CVST)是由多种病因所致的脑静脉系统狭窄或闭塞,颅内静脉回流受阻,颅内压增高的一种脑血管病。目前,其最常用的影像学诊断方法主要有CT、MRI、MRV以及DSA等。MRI联合MRV检查可以直接反应静脉窦内血栓病变,被认为是诊断CVST的首选方法;而DSA可以动态观察颅内血液循环,是CVST最可靠、最直接的诊断方法。在治疗方面,病因治疗、抗凝治疗、血管内治疗是其主要的治疗方法。其中,由于抗凝治疗可以防止血栓扩展,促进血栓溶解,被认为是治疗CVST的首选方法,而对于急性期CVST患者以及抗凝治疗无效的患者,血管内治疗则是一种安全而有效的治疗方式。本文就国内外有关CVST的不同影像学诊断及治疗方法的优缺点展开综述。
Cerebral venous sinus thrombosis (CVST) is a kind of cerebrovascular disease caused by a variety of causes of cerebral venous system stenosis or occlusion, blocked intracranial venous reflux, and increased intracranial pressure. At present, the most commonly used diagnostic imaging methods are CT, MRI, MRV and DSA. MRI combined with MRV examination can directly reflect the sinus thrombosis lesions, is considered the preferred method of diagnosis of CVST; and DSA can be dynamic observation of intracranial blood circulation, CVST is the most reliable and most direct diagnostic method. In the treatment, the cause of treatment, anticoagulant therapy, endovascular treatment is its main treatment. Among them, as anticoagulant therapy can prevent thrombus expansion and promote thrombolysis, is considered the preferred method of treatment of CVST, and for patients with acute CVST and anticoagulant therapy in patients with endovascular treatment is a safe and effective treatment the way. This review summarizes the advantages and disadvantages of different imaging diagnosis and treatment methods of CVST at home and abroad.