Learning objectives
1.
To provide a pictorial review of the pitfalls encountered in the MR diagnosis of dural venous sinus thrombosis (DVST).
2.
To discuss troubleshooting methods along with each pitfall in or order to improve accuracy.
Background
In Neuroradiology,
DVST is commonly encountered.
It is reversible but associated withgrave outcomes if not treated promptly.The clinical manifestations are varied ranging fromheadaches to altered mentation.
Therefore imaging plays a crucial role in its diagnosis.
CT scans are usually the first line of imaging.
However,
exposure to radiation,
use of contrast agents and the inability of the modality to age thrombi have led to a steady decline in the use ofCT scans.
Over the years,
MR imaging has become prevalent in the diagnosis of DVST....
Findings and procedure details
To simply understanding our dataset will be discussed under four categories.
GROUP I: ERRORSON CONVENTIONAL SEQUENCES
1.
Pitfalls in acuteDVST
In acute DVST (0–5 days),
thrombi generally are isointense on T1W and hypointense T2W images.
This is due to deoxyhemoglobin within the red blood cells trapped in the thrombus meshwork.
As a result,
acute DVST may mimica normal flow void (1,
2).
CE-MRI or TOF-MRV is essential in diagnosis at this stage (1).
On unenhanced conventional MR imaging comparison with the signal on the gradient-recalled...
Conclusion
Though MR imaging has revolutionized the management of DVST,
it is accompanied by multiple artifacts.
Recognition ofmasqueraders and mimics of DVST as well as techniques to rectify artifacts is not only essential in the accurate diagnosis but also critical in patient triage and treatment.
Personal information
Dr.
Vivek Pai
Clinical Fellow,Department of Neuroradiology,
National Neuroscience Institute,Singapore.
Email:
[email protected]
Dr.Bela Purohit
Consultant,Department of Neuroradiology,
National Neuroscience Institute,
Singapore.
Singapore.
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