title: Diffusion- and perfusion-weighted magnetic resonance imaging in deep cerebral venous thrombosis.
abstract: BACKGROUND
  Diffusion-weighted (DWI) and perfusion-weighted (PI) MRI are highly sensitive techniques for early diagnosis of arterial infarction, but little data on venous cerebral ischemia are available. We describe a case in which DWI, PI, and fast T2-weighted sequences were performed in the acute phase of deep cerebral venous thrombosis (CVT).
  
  
  METHODS
  An 11-year-old girl with Crohn's disease developed deep CVT in which extensive edema was shown in the deep gray matter on T2-weighted sequence images. Isotropic echo-planar DWI demonstrated a local augmentation of the apparent diffusion coefficient (1.1 to 1.6x10(-3) mm2/s), consistent with vasogenic edema. In dynamic contrast-enhanced PI, the regional cerebral blood volume was increased and the passage time of the contrast bolus was markedly prolonged. Clinically, the patient recovered totally after intravenous full-dose heparinization. T2 abnormalities, apparent diffusion coefficient values (0.8 to 0.92x10(-3) mm2/s), and brain perfusion alterations resolved without damage to brain tissue.
  
  
  CONCLUSIONS
  Unlike arterial infarction, DWI demonstrated vasogenic edema in a patient with deep CVT, which proved to be reversible in follow-up magnetic resonance imaging. PI showed areas with extensive venous congestion, but perfusion deficits were missing. Therefore, we believe that DWI and PI may play a role in detecting venous congestion in CVT and in prospective differentiation of vasogenic edema and venous infarction.
authors.affiliation: Department of Radiology, University of Bonn, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Keller
authors.forename: S
authors.initials: S
authors.lastname: Flacke
authors.forename: H
authors.initials: H
authors.lastname: Urbach
authors.forename: H H
authors.initials: HH
authors.lastname: Schild
mesh_terms: D001929:Brain Edema / Q000175:diagnosis*; D002545:Brain Ischemia / Q000175:diagnosis; D002550:Cerebral Veins; D002648:Child; D005260:Female; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*