Importance of T2*-weighted gradient-echo MRI for diagnosis of cortical vein thrombosis

MR Imaging Features of Isolated Cortical Vein Thrombosis: Diagnosis and Follow-Up

“…Hypointensity on T2*GE images of the thrombosed vein has been reported in only isolated cases. 5,6,17,18 In 8 patients with ICoVT selected from a large series of CVT (6.3%), we found a typical MSE at (Fig 4B, arrow). CϪE, On coronal images in the same plane, the aspect of a cord sign is visualized at the surface of the cortex, hyperintense on T1-and T2-weighted images (arrow, C and D) and hypointense on the T2*GE image (E).…”

“…Recently, the use of a T2*-weighted gradient-echo (T2*GE) sequence very sensitive to all paramagnetic products of hemoglobin was also found particularly useful for early diagnosis of CVT. [4][5][6][7][8] Isolated CVT (ICoVT) (ie, without sinus involvement) appears extremely rare and has been mainly reported as isolated case reports or in small series. [9][10][11][12][13][14][15][16][17][18] ICoVT is particularly difficult to diagnose by using only T1-weighted, T2-weighted, and MRV imaging for different reasons: 1) Cortical veins are extremely variable in number, size, and location, 2) occluded small veins at the cortical level are difficult to identify by using these MR images, and 3) only the occlusion of the largest veins is detectable on MRV.…”

Cerebral Venous and Dural Sinus Thrombosis*

“…This -and the fact that an established gold standard for this diagnosis is still lacking -hampers their radiologic evaluation [15]. Thus, isolated CVTs have mostly been described in case reports or in small series [10,[16][17][18][19][20][21]. Yet, more recently, with the advent of modern magnetic resonance (MR) techniques (see below), more and more cases are being reported, raising the suspicion that isolated CVTs indeed are more common than previously thought [11,12,[22][23][24].…”

Incidental Acute Infarcts Identified on Diffusion-Weighted Images: A University Hospital-Based Study: Fig 1.

“…Given that DWI has a unique contrast property and a relatively short acquisition time, this imaging technique has been incorporated into many routine brain MR protocols, including, among others, protocols for strokes, [18][19][20][21] headaches, seizures, and tumors. [22][23][24] Over the past few years, we have used DWI for our routine brain protocol assuming that incidental infarcts would be identified on DWI performed in a general patient population. Although relatively uncommon given the total number of MR examinations that were done, a number of patients with incidental acute or subacute infarcts were identified.…”