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Cavernous Sinus and Inferior Petrosal Sinus Flow Signal on Three-Dimensional Time-of-Flight MR Angiography

Serge Ouanounoua, Thomas A. TomsickGo,a, Charles Heitsmana and Christy K. Hollanda

a From the Department of Radiology, Section of Neuroradiology, University Hospital, 234 Goodman St, ML 0742, Cincinnati, OH 45219.



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  		FIG 1. A and B, 3D TOF MR angiograms (42/6.9) show grade 2 posterior cavernous sinus signal and grade 3 inferior petrosal sinus signal on both MIP (A, arrows) and source (B, arrows) images.



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  		FIG 2. 12-year-old girl with chemosis, proptosis, and bruit after motor vehicle accident.

A, Right ICA arteriogram 4 months after accident shows type A direct CCF, with dilated superior-petrosal sinus-cavernous junction (arrow) but incomplete opacification of the inferior petrosal sinus.

B, MR angiographic source images 2 years after treatment show bilateral posterior cavernous sinus signal (arrows), unchanged from 1 year earlier. No clinical signs of patent CCF were present, and an arteriogram was not performed. This case illustrates the dilemma of cavernous sinus signal as a marker for CCF.



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  		FIG 3. 81-year-old man with vertigo.

A, Oblique MIP shows bilateral (left > right) posterior cavernous sinus signal (arrow) and inferior petrosal sinus flow. Note saturation of flow signal at slab overlap (arrowhead).

B, Lateral MIP shows cavernous sinus signal (arrow).





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X