Abstract:
Cerebral Venous
Thrombosis (CVT) is a relatively uncommon condition which is notoriously difficult
to diagnose because of its variable modes of onset, its wide spectrum of signs and
symptoms. MR Venography (MRV) imaging plays a primary role in the noninvasive
diagnosis. New development of MR techniques such as susceptibility
weigted imaging detects the magnetic susceptibility effect of blood products such as
deoxyhemoglobin enables assessment of venous vasculer structure. SWAN
(Susceptibility Weighted Angiography) is a new susceptibility weighted recalled
echo (T2*GRE) method offering less noise than other methods. This study aims to
evaluate the diagnostic value of SWAN and Diffusion weighted imaging (DWI) in
patients who are detected to be CVT with PC-MRV on different stages and
segments. Total of 1070 patients who underwent 3 Tesla Phase- Contrast MR
Venography and MR imaging from Agust 2013 to January 2016 in our institution are
retrospectively reviewed. As a result of keyword search for the terms "Cerebral Venous Thoromobosis" on imagine reports, a total of 107 case of CVT are identified in our radiology database system. The evaluation of SWAN imaging revealed to
exaggerated signal changing is often seen because of the increased susceptibility
effect of certain paramagnetic breakdown products of hemoglobin depending on
stage of thrombus. We demonstrated that SWAN sequence have significantly higher
diagnostic value for detecting both acute and early subacute thrombosis. However,
susceptibility artifacts from the skull base and slow flow of sigmoid sinus may limit
the assessment of thrombosis in transverse and sigmoid sinuses. DWI may provide
an additional clue for the diagnosis of CVT but it does not have higher sensitivity
compared to the other methods.
