Unilateral Nonvisualization of a Transverse Dural Sinus on Phase-Contrast MRV: Frequency and Differentiation from Sinus Thrombosis on Noncontrast MRI

Published on Jan 1, 2020in American Journal of Neuroradiology3.825
· DOI :10.3174/AJNR.A6337
Yu-Ming Chang8
Estimated H-index: 8
(BIDMC: Beth Israel Deaconess Medical Center),
Anna Luisa Kühn5
Estimated H-index: 5
(BIDMC: Beth Israel Deaconess Medical Center)
+ 3 AuthorsRafeeque A. Bhadelia28
Estimated H-index: 28
(BIDMC: Beth Israel Deaconess Medical Center)
Sources
Abstract
BACKGROUND AND PURPOSE: Unilateral decreased/nonvisualization of a transverse dural sinus on MRV poses a diagnostic dilemma when gadolinium administration is contraindicated. We determined the frequency of unilateral decreased/nonvisualization of the transverse dural sinus and the performance of pregadolinium MR imaging sequences in diagnosing transverse sinus thrombosis in the presence of unilateral decreased/nonvisualization on phase-contrast MRV. MATERIALS AND METHODS: We conducted a retrospective review of consecutive 3D phase-contrast MRV (VENC, 30 cm/s) and routine brain imaging (noncontrast sagittal T1, axial T2, FLAIR, DWI, GRE, and postgadolinium 3D-MPRAGE images) performed during a 3-year period for a total of 208 patients. Nonvisualization of a transverse dural sinus was defined as ≥50% nonvisualization of the transverse sinus caliber versus the contralateral side on MRV. Noncontrast imaging findings were considered abnormal when hyperintense signal was present on T2, FLAIR, T1, and DWI, and there were T2* blooming artifacts on GRE and DWI. Postgadolinium 3D-MPRAGE was used to confirm the diagnosis of transverse sinus thrombosis. RESULTS: Nonvisualization of a transverse dural sinus was observed in 72/208 (34.6%) patients on MRV; 56/72 (77.8%) were without transverse sinus thrombosis, and 16/72 (22.2%) patients had transverse dural sinus thrombosis. Nonvisualization of a transverse dural sinus was seen in 56/192 (29.2%) patients without transverse sinus thrombosis and 16/16 (100%) with transverse sinus thrombosis. Abnormal findings on DWI (transverse sinus hyperintense signal or T2* blooming artifact) are 93.8% sensitive and 100.0% specific for transverse sinus thrombosis. Other noncontrast MR imaging sequences ranged from 56.3%–68.8% sensitive and 91.1%–100.0% specific. CONCLUSIONS: Nonvisualization of a transverse dural sinus is a frequent phenomenon on phase-contrast MRV. DWI can be effectively used to exclude sinus thrombosis when nonvisualization of a transverse dural sinus is a diagnostic conundrum on phase-contrast MRV and contrast-enhanced studies are contraindicated.
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References31
Newest
#1Bang J. Guo (Southern Medical University)H-Index: 1
#2Zhen L. Yang (NU: Nanjing University)H-Index: 2
Last. Long J. Zhang (Southern Medical University)H-Index: 3
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In the past 4 years, a number of publications described a dose-dependent deposition of gadolinium in the brain both in adults and children, seen as high signal intensities in the dentate nucleus and globus pallidus on unenhanced T1-weighted images. Postmortem human or animal studies have confirmed gadolinium deposition in these areas of T1-hyperintensity, raising new concerns regarding the safety of gadolinium-based contrast agents (GBCAs). Residual gadolinium is retained not only in brain regio...
Source
#1Adam A. Dmytriw (U of T: University of Toronto)H-Index: 17
#2Jin Soo A. Song (U of T: University of Toronto)H-Index: 2
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Purpose This review article aims to discuss the pathophysiology, clinical presentation, and neuroimaging of cerebral venous thrombosis (CVT). Different approaches for diagnosis of CVT, including CT/CTV, MRI/MRV, and US will be discussed and the reader will become acquainted with imaging findings as well as limitations of each modality. Lastly, this exhibit will review the standard of care for CVT treatment and emerging endovascular options.
Source
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The anatomical variations of the confluence of sinuses were examined, focusing on the continuity of the superior sagittal sinus (SSS) and the transverse sinuses (TSs). In the 142 specimens studied, there were 72 symmetric cases (50.7%) and 70 asymmetric cases (49.3%). The symmetric group (no dominant type) was categorized into 34 cases of bifurcation (23.9%) and 38 cases of confluence (26.8%). The asymmetric group was categorized into 54 cases of the right-dominant type (38.0%) and 16 cases of t...
Source
#1Antonio ArauzH-Index: 30
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Background Hypoplasia of the transverse sinus (TS) is a common anatomical variation. However, the relationship between TS hypoplasia and venous thrombosis has not been studied. We analyzed the hypothesis that TS hypoplasia is a predisposing factor for ipsilateral thrombosis. Materials and methods We retrospectively evaluated 20 confirmed cases with isolated TS thrombosis and 43 age- and sex-matched controls. TS thrombosis and hypoplasia were diagnosed using both computed tomography and magnetic ...
Source
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BACKGROUND AND PURPOSE: Signs suggestive of unexpected dural venous sinus thrombosis are detectable on routine MR imaging studies without MRV. We assessed performance characteristics and interrater reliability of routine MR imaging for the diagnosis of dural venous sinus thrombosis, focusing on the superior sagittal, transverse, and sigmoid sinuses. MATERIALS AND METHODS: This case series included 350 patients with MRIs performed with contrast-enhanced MRV and 79 patients with routine MRIs perfo...
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OBJECTIVE. The purpose of this study is to assess the performance of routinely used MRI sequences with and without contrast enhancement in the diagnostic evaluation of dural venous sinus thrombosis (DVST). MATERIALS AND METHODS. We identified consecutive patients older than 18 years who underwent concurrent standardized brain MRI and contrast-enhanced (CE) MR venography (MRV) examinations for suspected DVST. The seven MRI sequences that were used (axial unenhanced T1-weighted, T1-weighted CE, T2...
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In previous studies of transverse sinus (TS) hypoplasia, discrepancies between TS diameter measured by magnetic resonance venography (MRV) and contrast T1-weighted magnetic resonance (contrast T1) were observed. To investigate these discrepancies, and considering that TS hypoplasia is associated with neurological disorders, we performed a post hoc analysis of prospectively collected data from 3 case–control studies on transient global amnesia (TGA), transient monocular blindness (TMB), and panic...
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