Anatomic variants and artefacts in non enhanced MRV – potential pitfalls in diagnosing cerebral venous sinus thrombosis (CVST)

Pallewatte, Aruna; Tharmalingam, T.; Liyanage, Nisansala

doi:10.4038/sljr.v2i1.23

Cited by 4 publications

(15 citation statements)

References 2 publications

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“…MRV can detect the thrombus and can assess the spontaneous recanalization or recanalization following therapy. Total recanalization is not mandatory for symptomatic recovery, and the presence of collateral pathways may also be identified in MRV [ 95 , 96 ]. ( Table 2 ) ( Figure 5 ) [ 81 ].…”

Section: Resultsmentioning

confidence: 99%

“…MRV may be done without contrast enhancement (using the TOF technique or phase contrast technique) or with a contrast-enhanced technique [ 95 , 96 ].…”

Section: Resultsmentioning

confidence: 99%

“…The two-dimensional (2D-TOF) method (with 1.5, and 3-mm thick slices in the coronal and axial planes) represents the most frequent technique and is essential in pregnant or breastfeeding women, as well as in case of severe renal failure, where contrast enhancement is prohibited. It detects the absence of flow signal (absence of opacification) of dural sinuses in the case of an occlusion of the vessel, though interpretation can be confounded by normal anatomic variants such as sinus hypoplasia and asymmetric flow [ 12 , 95 , 96 ].…”

Section: Resultsmentioning

confidence: 99%

“…The indirect signs of CVT include delayed emptying, collateral venous circulation, dilated veins, and tortuous collateral cortical veins (corkscrew veins) [ 2 ]. The 2D-TOF technique is superior to its 3D counterpart due to a relative lack of saturation effects and superior sensitivity in the setting of slow venous flow but has a low sensitivity to small vessels with a slow flow [ 95 , 96 ].…”

Section: Resultsmentioning

confidence: 99%

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An Integrated Approach on the Diagnosis of Cerebral Veins and Dural Sinuses Thrombosis (a Narrative Review)

Jianu

Dan

et al. 2022

Life

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(1) Objective: This review paper aims to discuss multiple aspects of cerebral venous thrombosis (CVT), including epidemiology, etiology, pathophysiology, and clinical presentation. Different neuroimaging methods for diagnosis of CVT, such as computer tomography CT/CT Venography (CTV), and Magnetic Resonance Imaging (MRI)/MR Venography (MRV) will be presented. (2) Methods: A literature analysis using PubMed and the MEDLINE sub-engine was done using the terms: cerebral venous thrombosis, thrombophilia, and imaging. Different studies concerning risk factors, clinical picture, and imaging signs of patients with CVT were examined. (3) Results: At least one risk factor can be identified in 85% of CVT cases. Searching for a thrombophilic state should be realized for patients with CVT who present a high pretest probability of severe thrombophilia. Two pathophysiological mechanisms contribute to their highly variable clinical presentation: augmentation of venular and capillary pressure, and diminution of cerebrospinal fluid absorption. The clinical spectrum of CVT is frequently non-specific and presents a high level of clinical suspicion. Four major syndromes have been described: isolated intracranial hypertension, seizures, focal neurological abnormalities, and encephalopathy. Cavernous sinus thrombosis is the single CVT that presents a characteristic clinical syndrome. Non-enhanced CT (NECT) of the Head is the most frequently performed imaging study in the emergency department. Features of CVT on NECT can be divided into direct signs (demonstration of dense venous clot within a cerebral vein or a cerebral venous sinus), and more frequently indirect signs (such as cerebral edema, or cerebral venous infarct). CVT diagnosis is confirmed with CTV, directly detecting the venous clot as a filling defect, or MRI/MRV, which also realizes a better description of parenchymal abnormalities. (4) Conclusions: CVT is a relatively rare disorder in the general population and is frequently misdiagnosed upon initial examination. The knowledge of wide clinical aspects and imaging signs will be essential in providing a timely diagnosis.

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Section: Resultsmentioning

confidence: 99%

“…MRV may be done without contrast enhancement (using the TOF technique or phase contrast technique) or with a contrast-enhanced technique [ 95 , 96 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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An Integrated Approach on the Diagnosis of Cerebral Veins and Dural Sinuses Thrombosis (a Narrative Review)

Jianu

Dan

et al. 2022

Life

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“…The confluence of the sinuses (torcular herophili) is formed by the junction of SSS, straight, occipital and transverse sinuses [1,[5][6][7]. Dural sinuses and encephalic veins anatomy [70].…”

Section: Dural Sinusesmentioning

confidence: 99%

Cerebral Vein and Dural Sinus Thrombosis

Jianu¹,

Jianu²,

Munteanu³

et al. 2018

Ischemic Stroke of Brain

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Cerebral venous thrombosis (CVT) is an uncommon disorder in the general population. At least 1 risk factor can be identified in 85% of patients with CVT. Because of the high frequency of thrombophilia among patients with CVT, screening for hypercoagulable conditions should be performed. Two pathophysiological mechanisms contribute to their highly variable clinical presentation. Four major syndromes have been described: isolated intracranial hypertension, focal neurological abnormalities, seizures, and encephalopathy. Cavernous sinus thrombosis represents the single CVT which produces a characteristic clinical syndrome. Head Computed Tomography is the most frequently performed imaging study, but Magnetic Resonance Imaging of the head combined with Magnetic Resonance venography are the most sensitive studies. Acute phase therapy for CVT focuses on anticoagulation, management of seizures, increased intracranial pressure, and prevention of cerebral herniation. The majority of patients have a complete or partial recovery, however they have an increased incidence of venous thromboembolism. Clinical and imaging follow-ups 3-6 months after diagnosis are recommended to assess for recanalization.

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Visualising the Dural Venous Sinuses Using Volume Tracing, a Novel Approach

Toit

Louw

2022

Advances in Experimental Medicine and Biology

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Anatomic variants and artefacts in non enhanced MRV – potential pitfalls in diagnosing cerebral venous sinus thrombosis (CVST)

Cited by 4 publications

References 2 publications

An Integrated Approach on the Diagnosis of Cerebral Veins and Dural Sinuses Thrombosis (a Narrative Review)

An Integrated Approach on the Diagnosis of Cerebral Veins and Dural Sinuses Thrombosis (a Narrative Review)

Cerebral Vein and Dural Sinus Thrombosis

Visualising the Dural Venous Sinuses Using Volume Tracing, a Novel Approach

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