Cerebral venous thrombosis and multidetector CT angiography: tips and tricks.
Because of the great diversity of clinical features, its unforeseeable evolution, and a small proportion of cases that will worsen in the acute phase, cerebral venous thrombosis must be diagnosed as early as possible so that specific treatment can be started, typically transcatheter thrombolysis or systemic anticoagulation. Unenhanced computed tomography (CT) is usually the first imaging study performed on an emergency basis. Unenhanced CT allows detection of ischemic changes related to venous insufficiency and sometimes demonstrates a hyperattenuating thrombosed dural sinus or vein. Helical multidetector CT venography with bolus power injection of contrast material and combined use of two-dimensional and three-dimensional reformations (maximum intensity projection, integral display, and volume rendering) provides exquisite anatomic detail of the deep and superficial intracranial venous system and can demonstrate filling defects. However, common variants of the sinovenous system should not be mistaken for sinus thrombosis. A comprehensive diagnostic approach facilitates imaging of cerebral venous thrombosis with multidetector CT.
Rodallec
Mathieu H
MH
Department of Radiology, Fondation Hôpital Saint-Joseph, 185 rue Raymond Losserand, 75674 Paris cedex 14, France. mathieurodallec@hotmail.com
Krainik
Alexandre
A
Feydy
Antoine
A
Hélias
Annick
A
Colombani
Jean-Michel
JM
Jullès
Marie-Christine
MC
Marteau
Véronique
V
Zins
Marc
M
D002533:Cerebral Angiography / Q000379:methods*; D002550:Cerebral Veins / Q000000981:diagnostic imaging*; D003287:Contrast Media; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D010690:Phlebography / Q000379:methods*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011856:Radiographic Image Enhancement / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000295:instrumentation* / Q000379:methods*; D020246:Venous Thrombosis / Q000000981:diagnostic imaging*
D003287:Contrast Media