More Reliable Noninvasive Visualization of the Cerebral Veins and Dural Sinuses: Comparison of Three MR Angiographic Techniques

PURPOSE: To compare the visualization of cerebral veins and dural sinuses at contrast material-enhanced three-dimensional (3D) fast low-angle shot (FLASH) magnetic resonance (MR) angiography, time-of-flight (TOF) MR angiography, and phase-contrast MR angiography. MATERIALS AND METHODS: The authors prospectively compared the two-dimensional source images, multiplanar reconstructed images, and maximum intensity projection angiograms obtained at contrast-enhanced 3D radio-frequency-spoiled FLASH MR angiography in 20 patients with those obtained at TOF and phase-contrast MR angiographic examinations. Two neuroradiologists in consensus determined the number of visualized cortical veins and graded the quality of visualization of veins and sinuses as intense and continuous, faint and continuous, or noncontinuous. Statistical analysis was performed with the nonparametric sign test and the Wilcoxon matched pairs sign rank test. RESULTS: The cortical veins, inferior sagittal sinus, and cavernous sinuses were visualized best with FLASH MR angiography (P <.003). The Trolard and Labbé veins were visualized equally well with the FLASH and TOF sequences. For septal, internal cerebral, and Rosenthal left basal vein visualization, phase-contrast MR angiography was inferior to the FLASH and TOF MR angiographic examinations (P <.05). The quality of visualization of the thalamostriate and Galen veins and of the superior sagittal, rectal, and transverse sinuses was the same at all MR angiographic examinations. CONCLUSION: Three-dimensional FLASH MR angiography depicts some venous structures better than do TOF and phase-contrast MR angiographic examinations. The depiction of other veins is the same with 3D FLASH and TOF sequences.