Comprehensive Imaging Diagnosis of Cerebral Venous Sinus Thrombosis

Objective To evaluate the value of combined imaging examinations in diagnosis of cerebral venous sinus thrombosis(CVST). Methods Retrospective analysis of 18 CVST patients with CT,MRI,Multi-slice CT venography (MSCTV) ,three-dimensional contrast-enhanced MR venography (3D CE-MRV) and DSA imaging data. 18 cases of CVST were examined with CT and MRI,6 cases were examined with MSCTV,15 cases were examined with 3D CE-MRV,and 12 cases were examined with digital subtraction angiography(DSA). Results Among the 18 CVST cases,the superior sagittal sinus was involved in 8 cases,the transverse sinus in 2 cases,the sigmoid sinus in 4 cases,the straight sinus in 2 cases,and both the superi or sagittal and sigmoid sinus in the other 2 cases. CT examination could provide important clues for the early diagnosis of CVST ,especially MSCTV,but with low positive rate(33.3%). Direct signs of 18 CVST thrombosis could be displayed by MRI,showing disappearance of flow void effect of venous sinus,various signal intensities within CVST assessed in different stages of thrombosis. Indirect signs of 13 CVST thrombosis included cerebral edema,cerebral infarction and cerebral hemorrhage etc. Filling defect or interruption of venous sinus was found by 3D CE-MRV in all the 15 patients receiving this scan. The 12 patients were diagnosed correctly using DSA. Conclusion The combined imaging examinations has important value for the discovery,diagnosis and treatment of the CVST.