Value of MRI and MRV in the diagnosis of cerebral venous sinus thrombosis

Objective To evaluate magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) in the diagnosis of cerebral venous sinus thrombosis. Methods Twenty cases were included in this study and of them, male was 8 and female 12, with mean age 35 (9-54) years old. Spin-echo(SE) MRI was performed in the cases , 3 of them underwent the Gd-DTPA post-contrast study and 10 underwent cerebral venous TOF MR. The results in 13 cases were compared with those from plain CT . Among 20 cases, 3 were in the early acute phase (1w), 13 were in the subacute phase(1-2w) and the others were in the chronic phase(2 w). Results Nineteen cases were definitely diagnosed by SE MRI. The rest one in the acute phase was missed , but accurately determined with MRV. Thirteen cases couldn't be diagnosed by plain CT. In the acute phase, the MRI signal intensity of venous sinus thrombosis was very complex, which could be low, moderate or slightly high on T1WI whereas obvious low signal intensity on T2WI. In the subacute phase, the signal typically demonstrated short T1 and long T2. The signal gradually became low intensity in the chronic phase, and the venous sinus thrombosis was absorbed and then the corresponding venous sinus recanalled. The venous sinus thrombosis displayed on MRV occlusion and filling defects in the venous sinus. Conclusions MRI and MRV are the effective imaging modalities in the diagnosis and follow-up of the cerebral venous sinus thrombosis, superior to CT, and can replace invasive DSA.