Performance of Spin-Echo and Gradient-Echo T1-Weighted Sequences for Evaluation of Dural Venous Sinus Thrombosis and Stenosis

Abstract

Contrast-enhanced 3D GRE T1-weighted imaging is superior to SE T1-weighted imaging for the detection of dural venous sinus thrombosis and TS stenosis but does not substitute for dedicated MRV. Hyperintensity on unenhanced SE T1-weighted imaging is unreliable for the detection of dural venous sinus thrombosis.

MRI diagnosis of dural sinus—Cortical venous thrombosis: Immediate post-contrast 3D GRE T1-weighted imaging versus unenhanced MR venography and conventional MR sequences

“…Besides, we decided to evaluate DVSs in 10 sub-segments (cortical veins constituting one of them) which yielded overall 300 segments to evaluate the efficacy of different MRI techniques and this in turn increased the statistical power of the study. Saindane et al evaluated the diagnostic accuracy of spin-echo T1-weighted imaging, 3D GRE T1-weighted imaging, and contrastenhanced MR venography for the detection of dural venous sinus thrombosis and transverse sinus stenosis [9]. In the study performed by Saindane et al, there were thromboses in 23 DVS segments in 9 cases, whereas there were 67 thrombotic segments in 24 cases in this series.…”

“…To avoid this, 3D GRE T1-weighted sequence is always acquired immediately after contrast medium injection in our institution, which may be the reason for high sensitivity (92.5%) and accuracy (98.3%) rates found in this retrospective study. Although the specificity and the predictive values of contrast-enhanced 3D GRE T1-weighted sequence for detection of DVS thrombosis were up to 100% in the series by Saindane et al [9], its sensitivity was as low as 67%. Since the contrast-enhanced 3D GRE T1-weighted imaging sequence in their study had reportedly been acquired approximately 5 min after contrast injection and lasted approximately 4-5 min, gadolinium based contrast medium could have diffused into intravascular thrombus during this time and lead to enhancement of the thrombus material, hence obscuring its visualization as a filling defect.…”

“…DSA). There are several articles dealing with the accuracies of these different techniques [9][10][11][12][13][14][15][16]. However, in cases with nonspecific symptoms such as headache, nausea, vomiting or altered mental status, non-enhanced or contrastenhanced MR venography sequences are not performed routinely.…”

“…The reasons for this result are (i) the flow related artifacts, (ii) hyperintensity of the flow with low velocity, (iii) hypointensity of the acute thrombosis on both T1-and T2-weighted SE images, (iv) relatively high slice thickness of SE sequences that may reach up to 4-5 mm [9,18]. This low sensitivity and specificity rates of conventional MR sequences could be enhanced by preferring gradient echo (GE) sequences over SE sequences, but assessment of the accuracy of individual conventional MR sequences was not among the aims of this study and will not be further mentioned in this discussion.…”

Asymmetric Papilledema in Idiopathic Intracranial Hypertension

“…The presence of meningoceles, as defined by CSF containing structures outside the expected confines of the cranial vault, was recorded. The presence or absence and side of transverse sinus stenosis was evaluated from either the contrast-enhanced MRV, post-contrast T1-weighted (16), 2D TOF MRI, post-contrast CT, or transverse sinus flow voids on T2-weighted images when there was no contrast-enhanced image set. When possible, and before recording the aforementioned radiologic findings, cross-sectional area of both the right and left optic canal were measured using either pre-contrast volumetric 1 mm isotropic T1-weighted images, by reformatting into a coronal oblique plane orthogonal to the axis of each optic canal, or thin-section CT examination that was also reformatted in a similar fashion using 0.625 mm images to obtain cross sectional area (fig.…”