Utility of contrast-enhanced 3D turbo-flash MR angiography in evaluating the intracranial venous system

Abstract

The objective of this study was to compare the effectiveness of contrast-enhanced 3D turbo-flash and 2D time-of-flight (TOF) magnetic resonance angiography (MRA) sequences in the visualization and evaluation of the intracranial venous system. A prospective study was carried out on 41 patients referred to our Magnetic Resonance Imaging (MRI) unit with clinical findings suggestive of dural sinus thrombosis. Contrast-enhanced 3D turbo-flash and 2D TOF MRA sequences were performed, and the dural sinuses and cerebral veins were classified into five grades according to the quality of visualization and presence of thrombosis. We found the dural sinuses and cerebral veins to be normal in all sequences in 31 patients. Thrombosis of dural sinuses was detected in ten patients, with four of these ten cases found only in the contrast-enhanced 3D turbo-flash sequence. In general, complete visualization of cerebral veins and dural sinuses was significantly better accomplished with contrast-enhanced 3D turbo-flash MRA than with 2D TOF in either coronal or sagittal/oblique planes. Although 2D TOF MRA may be superior in detecting chronic dural sinus thrombosis, contrast-enhanced 3D turbo-flash MRA sequences may offer advantages for the early diagnosis and management of acute and subacute dural sinus thrombosis.

Current imaging modalities for diagnosing cerebral vein thrombosis – A critical review

“…respectively [61][62][63]70]. Furthermore, in studies that evaluated the diagnostic accuracy of MRI for visualization of cerebral veins (not necessarily in the setting of suspected CVT), contrast-enhanced MRI was found to be superior to non-contrast-enhanced MRI as well [66,[73][74][75][76][77][78].…”

Preoperative Evaluation of Venous Systems with Magnetic Resonance Venography in Parasagittal Meningiomas

“…It is no longer used for the routine diagnosis of brain tumors. In addition, catheter angiography with digital subtraction is invasive and features some complications, including cerebral infarction, injury of vascular walls, and hematoma in the punctured site, which cannot be ignor-edP (5,6) P . Magnetic Resonance venography (MRV) proved to be a reliable method to distinguish cerebral venous structures.…”

High Spatial Resolution and High Contrast Visualization of Brain Arteries and Veins: Impact of Blood Pool Contrast Agent and Water-Selective Excitation Imaging at 3T

“…However, TOF and PCA both have limitations, since they can be misleading in the presence of pathological flow patterns. Contrast-enhanced techniques are independent of flow but data are typically acquired during the first pass [4,6] and thus the scanning time is limited. However, it has recently been shown that timeresolved approaches (4D MRA) can also be obtained with separate data acquisition for the arterial and venous phases [9 -14] resulting in improved contrast for venous imaging, but spatial resolution in these contrast-enhanced approaches is limited and thus these techniques fail to visualize smaller cortical veins [15].…”

“…However, visualization of smaller veins is complicated since high-resolution time-of-flight techniques are typically limited to MR angiography and phase contrast techniques are very sensitive to flow patterns. As a consequence, contrast-enhanced MR angiography and MR venography have been implemented for the visualization of the veins, at the cost of spatial resolution [3,4,15]. Thus, a single high spatial resolution sequence with sufficient contrast of the arteries and veins in one data set may be useful in the daily clinical routine.…”