AJDRAJNR - American Journal of Neuroradiology

Published ahead of print on December 18, 2008
doi: 10.3174/ajnr.A1332
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MR Imaging Features of Isolated Cortical Vein Thrombosis: Diagnosis and Follow-Up

M. Boukobzaa, I. Crassardb, M.G. Bousserb and H. Chabriatb

a Department of Neuroradiology, Hopital Lariboisiere, AP-HP, Paris, France
b Department of Neurology, Hopital Lariboisiere, AP-HP, Paris, France


Figure 1
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  		Fig 1. Patient 6. A and B, Initial MR imaging at day 7. On T2*GE images, linear hypointensity is seen in the right precentral sulcus, due to MSE at site of the thrombosed veins (small arrow) and hypointense areas corresponding to cortical hemorrhages (long arrows). C, On T1-weighted image, only swollen gyri (arrow) are identified.


Figure 2
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  		Fig 2. Patient 6. A, Follow-up at month 3 reveals cortical hyperintensity on the T1-weighted image due to petechial hemorrhages. B, On the T2*GE image (same plane as in Fig 1A), note reduced but still visible MSE at the site of venous thrombosis (arrow), as well as petechial hemorrhages. C, At month 12, T1-weighted imaging findings are normal on T2*GE image (arrow); MSE is still identified.


Figure 3
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  		Fig 3. Patient 7. MR imaging at initial examination at day 5. An extra-axial band corresponding to the thrombosed vein of Labbé appears as a marked MSE on T2*GE image (A, arrow), isointense on T1 (B, arrow), hypointense on FLAIR sequence (C, arrow), and as a signal-intensity loss on DWI (D, arrow).


Figure 4
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  		Fig 4. Patient 8. Initial MR imaging at day 3. T2*GE shows MSE in the thrombosed cortical vein (A, arrow) and the hematoma, appearing on the T1-weighted image as a mass of mixed signal intensity (B, arrow).


Figure 5
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  		Fig 5. Patient 8. A, Follow-up at day 15. MSE is still identified in the thrombosed vein. B, A hyperintense spot is present in the lumen of a cortical vein on the T1-weighted image (arrow), appearing as a flow void on the initial T1-weighted image (Fig 4B, arrow). C–E, On coronal images in the same plane, the aspect of a cord sign is visualized at the surface of the cortex, hyperintense on T1- and T2-weighted images (arrow, C and D) and hypointense on the T2*GE image (E). The underlying hematoma is well identified on T1- and T2*GE images.





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