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Diffusion- and Perfusion-Weighted MR Imaging of Dural Sinus Thrombosis

James ManzioneGo,a, George C. Newmana, Avishai Shapiroa and Ramon Santo-Ocampoa

a From the Departments of Radiology (J.M., A.S., R.O.) and Neurology (G.C.N.), State University of New York at Stony Brook.



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  		FIG 1. A, Sagittal T1-weighted image showing thrombus in the superior sagittal sinus.

B, Axial T2-weighted fast spin-echo image showing small cortical infarct in the posterior frontal lobe.

C, Diffusion-weighted anisotropic image, slice (z) direction showing increased signal in the right hemisphere. The denser frontal lesion corresponds to the signal abnormality seen on conventional imaging.

D, Mean transit time map from perfusion-weighted imaging showing a large area of prolonged mean transit time in the right hemisphere.

E, Contrast venography of the sagittal sinus showing venous thrombosis with absent flow.

F, Post-treatment venography showing restoration of flow in the sagittal and transverse sinuses. (cont'd ->)



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  		FIG 1. (cont'd) G, Post-treatment diffusion-weighted image of the same slice as in C showing an area of persistent, although smaller, signal abnormality in the right frontal region and complete resolution of the parietal region defect, presumably representing reversible parenchymal changes of intracellular water accumulation.

H, Post-treatment perfusion-weighted imaging showing marked improvement in the mean transit delay.

I, Post-treatment axial T2-weighted fast spin-echo image unchanged from images prior to treatment. The small cortical infarct persists and no new lesion has developed in the parietal lobe.

J, 1-year follow-up axial T2-weighted fast spin-echo image showing extremely small residual cortical lesion.





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