Neuroimaging of Cerebral Venous Thrombosis

Abstract

Early and accurate diagnosis of cerebral venous thrombosis (CVT) is possible with the help of computed tomography (CT) scan and magnetic resonance imaging (MRI). Empty delta sign on postcontrast CT is present in only up to 30% of the cases. The role of CT venography is not yet established, but it is emerging as an effective modality for diagnosis of CVT. T2* MRI sequence is superior to spin echo in detecting CVT and small hemor rhages. MR venography is considered the technique of choice for diagnosis and follow-up of CVT, but in certain cases, MRI could be superior as it shows the thrombus itself and not just the absence of signal as seen on MR venography. Diffusion-weighted imaging is a relatively new MRI technique that is extremely sensitive in detecting acute arterial strokes and can distinguish cytotoxic and vasogenic edema. The presence of hyperintense signal on diffusion-weighted imaging in the occluded veins or sinuses at the time of diagnosis may predict a low rate of vessel recanalization. Contrast angiography should be strongly considered if isolated cortical vein thrombosis is suspected.

Intracranial venous collaterals in cerebral venous thrombosis: clinical and imaging impact

“…A previous study8 in a smaller sample of patients reported that 38% of patients experienced collateral formation. In our study, according to Qureshi’s classification system,8 12 collaterals were present in 88% of patients. To the best of our knowledge, this is the largest sample of patients with CVT who have undergone collateral vessel assessment to determine its relationship with outcome.…”

No association of abnormal cranial venous drainage with multiple sclerosis: a magnetic resonance venography and flow-quantification study

“…A major point of criticism is that the concept of CCSVI is mainly based on ECD and TCCS methods, which are strongly operator-dependent, and that intracranial venous blood flow is difficult to measure. In contrast, magnetic resonance venography (MRV) is a non-invasive, sensitive, operator-independent technique for the evaluation of venous anatomy and pathological changes, and is widely used in the clinical setting 9 10. Such an objective imaging technique is also needed in case treatment of a morphological abnormality is contemplated.…”

Soluble Thrombomodulin and Endothelial Cell Protein C Receptor Levels in Patients with Cerebral Venous and Sinus Thrombosis

“…The diagnosis of CVST was confirmed by magnetic resonance imaging and venography with and without contrast, or plain and contrast CT scan according to accepted criteria [9]. The study was approved by the research ethics committee of Isfahan University of Medical Sciences, and all subjects and controls had signed the informed consent form.…”