Imaging Dural Sinus Thrombosis

F. Allan Midyett1, Suresh Mukherji1, Laurie Fisher1

1 University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
Publication Name:  Current Protocols in Magnetic Resonance Imaging
Unit Number:  Unit A2.1
DOI:  10.1002/0471142719.mia0201s00
Online Posting Date:  May, 2001
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The acute onset of irreversible neurological deficit is referred to as a “stroke” and is the third leading cause of death and the major cause of adult long‐term disability in the United States. Obstruction of the venous sinuses by thrombosis accounts for ˜1% of strokes. Thrombosis of the superior saggital sinus is most frequent, with involvement of transverse, sigmoid, and cavernous sinuses occurring less often. Venous thrombosis may involve the dural sinuses, the deep venous system, and the superficial cortical veins separately or in any combination. This unit describes a for imaging dural sinuses by time‐of‐flight magnetic resonance venography (MRV).

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Table of Contents

  • Basic Protocol 1: Imaging Dural Sinuses by Time‐of‐Flight MRV
  • Commentary
  • Figures
  • Tables
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Literature Cited

Literature Cited
   Bianchi, D., Maeder, P., Bogousslavsky, J., Schnyder, P., and Meuli, R. 1998. Diagnosis of cerebral venous thrombosis with routine magnetic resonance: An update. Eur. Neurol. 40:179‐190.
   Cure, J.K. and Van Tassel, P. 1994. Congenital and acquired abnormalities of the dural venous sinuses. Seminars US, CT, Magn. Reson. Imaging 15:520‐539.
   Fischbein, N.J., Dillon, W.P., and Barkovich, A.J. 2000. Teaching Atlas of Brain Imaging. pp. 248‐249, 329‐332. Thieme, New York.
   Shellock, F.G. and Kanal, E. 1996. Magnetic Resonance Bioeffects, Safety and Patient Management. Lippincott Williams and Wilkins, Philadelphia.
   Tsai, F.Y., Wang, A., Matovich, V.B., Lavin, M., Berberian, B., Simonson, T.M., and Yuh, W.T. 1995. MR staging of acute dural sinus thrombosis: Correlation with venous pressure measurements and implications for treatment and prognosis. Am. J. Neuroradiol. 16:1021‐1029.
   Yuh, W.T., Simonson, T.M., Wang, A.M., Koci, T.M., Tali, E.T., Fisher, D.J., Simon, J.H., Jinkins, J.R., and Tsai, F. 1994. Venous sinus occlusive disease: MR findings. Am. J. Neuroradiol. 15:309‐316.
Key References
   Bianchi et al., 1998. See above.
  These authors describe the importance of MRI and MRV in the diagnosis and follow‐up of cerebral venous thrombosis. They point out how different signals on spin echo T1‐ and T2‐weighted images evolve according to hemoglobin degradation causing pitfalls and artifacts that must be recognized.
   Fischbein et al., 2000. See above.
  These authors afford a current concise look at dural sinus thrombosis. In addition to imaging findings, they discuss, clinical findings, treatment, complications, pearls, and pitfalls.
   Shellock and Kanal, 1996. See above.
  Covers a number of important patient management issues related to MR imaging, including recommended safety procedures, a list of metallic implants that have been tested for MR compatibility, and a list of other sources on MR safety.
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