Type:
Educational Exhibit
Keywords:
Neuroradiology brain, Vascular, CNS, MR, Education, Imaging sequences, Physics, Education and training
Authors:
V. B. Pai1, B. S. Purohit1, Y. Y. Sitoh2, K. Gupta3, B. Pai3; 1Singapore /SG, 2SINGAPORE/SG, 3MUMBAI, MA/IN
DOI:
10.26044/ecr2019/C-3698
Background
In Neuroradiology,
DVST is commonly encountered.
It is reversible but associated with grave outcomes if not treated promptly. The clinical manifestations are varied ranging from headaches 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 of CT scans.
Over the years,
MR imaging has become prevalent in the diagnosis of DVST.
Its non-ionizing property and superior contrast resolution,
help to identify thrombi and age them accurately.
Moreover,
time-of-flight MR Venograms (TOF-MRV) can be performed without contrast media with excellent results.
Contrast media used in MRI,
are seldom required in the detection of DVST and are reserved in cases which present with a clinical dilemma.
In our institution,
TOF-MRV is commonly used for the diagnosis of DVST,
though contrast-enhanced MRI (CE-MRI) may be performed based on the clinical indication. The downside is that MRI is plagued with a number of artifacts which limit diagnostic accuracy.
Sound knowledge of these artifacts is key in the evaluation of DVST and to avoid pitfalls.