Importance of T2*-weighted gradient-echo MRI for diagnosis of cortical vein thrombosis

Eur J Radiol. 2005 Nov;56(2):235-9. doi: 10.1016/j.ejrad.2005.05.010. Epub 2005 Jun 20.

Abstract

We examined six patients with isolated venous thrombosis (n = 2), or venous thrombosis combined with sinus thrombosis (n = 4) (CVT). The clinical symptoms were non-specific (acute cephalea, paresis, epileptic seizure, progressive speech disorder). All examinations were performed on a 1.5 T system (Magnetom Symphony, Siemens, Erlangen, Germany), maximum gradient field strength 30 mT/m, minimal gradient rise time 450 micros, according to the following protocol: Transverse T2-weighted turbo spin-echo (TSE), fluid attenuated inversion recovery (FLAIR), T1-weighted spin-echo (SE), before and after administration of contrast medium, T2*-weighted conventional gradient-echo (GRE), T2*-weighted spin-echo echo planar imaging (SE EPI), both without and with diffusion weighting as well as two-dimensional (2D) venous time-of-flight (TOF) MRA. The venous thromboses were best detectable in the T2*-weighted conventional GRE sequence in all patients. In two patients, the CVT was discernible only in this sequence. The sinus thrombosis was well discernible only in the T2*-weighted GRE sequence in only one case; in the remaining cases it was detectable only with difficulty. For these cases, other sequences such as SE, diffusion-weighted, or 2D-TOF-MRA sequence were superior. The T2*-weighted conventional GRE sequence was superior to the T2*-weighted SE EPI sequence in all patients. To sum up, it can be concluded, that T2*-weighted conventional GRE sequences are possibly the best method of detection of acute cortical vein thromboses. Therefore, it seems to be of benefit to integrate a T2*-weighted conventional GRE sequence into the MR-protocol for the diagnosis of isolated cortical vein thrombosis.

MeSH terms

  • Adult
  • Aged
  • Contrast Media
  • Diffusion Magnetic Resonance Imaging / methods
  • Echo-Planar Imaging / methods
  • Female
  • Humans
  • Image Enhancement / methods
  • Image Processing, Computer-Assisted / methods*
  • Intracranial Thrombosis / diagnosis*
  • Magnetic Resonance Angiography / methods
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Sinus Thrombosis, Intracranial / diagnosis*
  • Venous Thrombosis / diagnosis*

Substances

  • Contrast Media