Time-resolved MR angiography of the intracranial venous system: an alternative MR venography technique

Yiğit, Hasan; Turan, Aynur; Ergün, Elif; Koşar, Pınar Nercis; Koşar, Uğur

doi:10.1007/s00330-011-2330-0

Cited by 23 publications

(21 citation statements)

References 24 publications

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“…Except for two patients who did not have a lumbar puncture, IIH was diagnosed according to the modified Dandy criteria [20]: papilledema, symptoms of raised ICP, no other cause for raised ICP on brain MRI, no CVT on brain MRV, and normal CSF contents with elevated CSF opening pressure (≥25 cm of water). The diagnosis of CVT was based on classic MRI and MRV findings [17,19,21]. Demographic information was recorded, including age, gender, race and body mass index (BMI).…”

Section: Methodsmentioning

confidence: 99%

“…MRV source data and MIP images were evaluated for location and extent of any venous sinus stenosis and thrombosis. Thrombosis was identified on sagittal and axial T1 and T2WI and MRV as previously described [19,21]. TSS was identified on reformatted MRV images by visually evaluating the width of each transverse sinus and classifying the sinus as “stenotic” or “normal” as previously described [9].…”

Section: Methodsmentioning

confidence: 99%

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Magnetic Resonance Imaging Findings of Elevated Intracranial Pressure in Cerebral Venous Thrombosis Versus Idiopathic Intracranial Hypertension with Transverse Sinus Stenosis

Ridha¹,

Saindane

Bruce

et al. 2013

Neuro-Ophthalmology

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Purpose To determine whether MRI signs suggesting elevated intracranial pressure (ICP) are preferentially found in patients with idiopathic intracranial hypertension (IIH) than in those with cerebral venous thrombosis (CVT). Methods Among 240 patients who underwent standardized contrast-enhanced brain MRI/MRV at our institution between 9/2009 and 9/2011, 60 with abnormal imaging findings on MRV were included: 27 patients with definite IIH, 2 patients with presumed IIH, and 31 with definite CVT. Medical records were reviewed, and imaging studies were prospectively evaluated by the same neuroradiologist to assess for presence or absence of transverse sinus stenosis (TSS), site of CVT if present, posterior globe flattening, optic nerve sheath dilation/tortuosity, and the size/appearance of the sella turcica. Results 29 IIH patients (28 women, 19 black, median-age 28, median-body mass index, 34) had bilateral TSS. 31 CVT patients (19 women, 13 black, median-age 46, median-BMI 29) had thrombosis of the sagittal (3), sigmoid (3), cavernous (1), unilateral transverse (7), or multiple (16) sinuses or cortical veins (1). Empty/partially-empty sellae were more common in IIH (3/29 and 24/29) than in CVT patients (1/31 and 19/31) (p<0.001). Flattening of the globes and dilation/tortuosity of the optic nerve sheaths were more common in IIH (20/29 and 18/29) than in CVT patients (13/31 and 5/31) (p<0.04). Conclusion Although abnormal imaging findings suggestive of raised ICP are more common in IIH, they are not specific for IIH and are found in patients with raised ICP from other causes such as CVT.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Magnetic Resonance Imaging Findings of Elevated Intracranial Pressure in Cerebral Venous Thrombosis Versus Idiopathic Intracranial Hypertension with Transverse Sinus Stenosis

Ridha¹,

Saindane

Bruce

et al. 2013

Neuro-Ophthalmology

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“…DSA is also more time-consuming than 2D-TOF MRV and so is not suitable for prompt management if the disease condition changes. A recent study compared time-resolved imaging of contrast kinetics MRV with 2D-TOF MRV and 3D contrast-enhanced MRV to assess which technique was better for visualizing normal cerebral veins and dural venous sinuses 10. It was found that time-resolved imaging of contrast kinetics MRV was comparable to 3D contrast-enhanced MRV and provided better visualization than 2D-TOF MRV.…”

Section: Discussionmentioning

confidence: 99%

“…While digital subtraction angiography (DSA) was originally considered the gold standard for the diagnosis of CVFO, the most widely used noninvasive techniques for evaluating the dural sinuses and cerebral veins today are magnetic resonance venography (MRV) techniques 10. These techniques include 2D time-of-flight (TOF) MRV, 3D-TOF MRV, phase-contrast MRV, and phase-sensitive imaging MRV.…”

Section: Introductionmentioning

confidence: 99%

Early Diagnosis and Management of Cerebral Venous Flow Obstruction Secondary to Transsinus Fracture after Traumatic Brain Injury

et al. 2013

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Background and PurposeCerebral venous flow obstruction (CVFO) is a fatal complication of traumatic brain injury. To compare the outcomes of patients with CVFO secondary to traumatic-brain-injury-induced transsinus fracture who were diagnosed early versus those diagnosed late in the therapeutic course.MethodsIn total, 403 patients with transsinus fracture were reviewed retrospectively. The patients were divided into an early-diagnosis group (n=338) and a delayed-diagnosis group (n=65). The patients submitted to 2D time-of-flight magnetic resonance venography (2D-TOF MRV) and/or CT venography (CTV), depending upon the findings of intracranial pressure monitoring, in order to identify potentially complicated CVFO. These examinations took place within 3 days of the onset of malignant intracranial hypertension symptoms in the early-diagnosis group, and after an average of 7 days in the delayed-diagnosis group. Once diagnosed, patients received intravenous thrombolytic therapy with low-dose urokinase. Patients with massive transsinus epidural hematoma, depressed fracture, or cerebral hernia were treated surgically to relieve the compression and repair any damage to the venous sinuses.ResultsCerebral venous flow obstruction was much more severe in the delayed-diagnosis group than in the early-diagnosis group (p<0.001), and hence patients in the former group were given a higher dose of urokinase (p<0.001) for thrombolytic therapy. They were also significantly more likely to need surgery (48.1% vs. 20.6%, p=0.003) and had a higher mortality rate (37.0% vs. 4.1%, p<0.001). However, patients in both groups experienced a similarly favorable prognosis, not only with regard to functional outcome but also with respect to neuroradiological improvement, as evaluated by 2D-TOF MRV/CTV at the final follow-up (p=0.218).ConclusionsDelayed diagnosis can result in increased risk of surgery and death in the acute phase. Thrombolytic therapy with low-dose urokinase resulted in promising improvements in both functional and neuroradiological outcomes in all of the patients in this study, regardless of the time to diagnosis.

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“…This sign, known as the 'dense triangle' in CVST [12] , may be seen in about one-third of cases. MRI combined with MRV is reliable for use as the sole method for diagnosing this condition [13][14][15] .…”

Section: Discussionmentioning

confidence: 99%

Cerebral Venous Sinus Thrombosis Involving the Straight Sinus May Result in Infarction and/or Hemorrhage

Zhou

Li²,

Zhang³

et al. 2016

Eur Neurol

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Aim: We retrospectively investigated the clinical profiles and neuroimaging data of patients with documented cerebral venous sinus thrombosis (CVST) to analyze the relationship between the sites of CVST and clinical manifestations. Methods: A total of 68 patients, who were examined and treated at our hospital, were identified after review and their data were retrospectively analyzed. Results: Initial non-contrast CT scan showed a definite spontaneous hyperdensity of one or several sinuses in 47 patients (69.1%) and was normal in the remaining patients (30.9%). Furthermore, the χ² test revealed a significant difference (p = 0.001) in the infarction or hemorrhage rate between the patients with straight sinus thrombosis (SST; 19 of 28, 67.8%) and other subjects (9 of 39, 23.1%). Moreover, patients with SST had a 6.33-fold (95% CI 2.18-18.4) increased risk of infarction or hemorrhage. Conclusion: Our data suggested that infarction and/or hemorrhage was more common in CVST patients with SST.

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Time-resolved MR angiography of the intracranial venous system: an alternative MR venography technique

Cited by 23 publications

References 24 publications

Magnetic Resonance Imaging Findings of Elevated Intracranial Pressure in Cerebral Venous Thrombosis Versus Idiopathic Intracranial Hypertension with Transverse Sinus Stenosis

Magnetic Resonance Imaging Findings of Elevated Intracranial Pressure in Cerebral Venous Thrombosis Versus Idiopathic Intracranial Hypertension with Transverse Sinus Stenosis

Early Diagnosis and Management of Cerebral Venous Flow Obstruction Secondary to Transsinus Fracture after Traumatic Brain Injury

Cerebral Venous Sinus Thrombosis Involving the Straight Sinus May Result in Infarction and/or Hemorrhage

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