title: Neuroimaging findings in pediatric cerebral sinovenous thrombosis.
abstract: OBJECTIVE
  Pediatric cerebral sinovenous thrombosis (CSVT) is a potentially life-threatening condition which is usually diagnosed by MRI. We analyzed the signal changes of the thrombus over time and the role of diffusion-weighted/tensor imaging (DWI/DTI) in the diagnosis of CSVT.
  
  
  METHODS
  Clinical histories were reviewed for risk factors for CSVT, neurologic manifestation, and interval from onset of symptoms related to CSVT to the neuroimaging diagnosis. MRI studies were retrospectively evaluated for the appearance of thrombi on T1- and T2-weighted, fluid-attenuated inversion recovery (FLAIR), DWI/DTI, susceptibility-weighted imaging (SWI), and magnetic resonance venography (MRV) images.
  
  
  RESULTS
  Thirty-three children with CSVT were included in this study. Seventy-seven thrombi were found. Seventy-four thrombi could be identified on T1- or T2-weighted images (96 %), 72 thrombi were seen on DWI/DTI (94 %) and 68 on FLAIR (88 %). DWI showed restricted diffusion in 29 thrombi (40 %). Thrombi older than 1 day were more likely to have a T1-hyperintense signal (p = 0.002). No additional correlation between signal intensity and age of the thrombi was found. Intraparenchymal changes secondary to CSVT were seen in 11 children.
  
  
  CONCLUSIONS
  MR sequences individually are not sensitive enough to provide the diagnosis. DWI/DTI does not provide complementary diagnostic value. Approximation of the age of the thrombus is difficult because of poor correlation between signal intensity and age of the thrombi.
authors.affiliation: Section of Pediatric Neuroradiology, Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Charlotte R. Bloomberg Children's Center, Sheikh Zayed Tower, The Johns Hopkins University School of Medicine, Room 4174, 1800 Orleans Street, Baltimore, MD, 21287-0842, USA.
authors.forename: Matthias W
authors.initials: MW
authors.lastname: Wagner
authors.forename: Thangamadhan
authors.initials: T
authors.lastname: Bosemani
authors.forename: Alexander
authors.initials: A
authors.lastname: Oshmyansky
authors.forename: Andrea
authors.initials: A
authors.lastname: Poretti
authors.forename: Thierry A G M
authors.initials: TA
authors.lastname: Huisman
mesh_terms: D000293:Adolescent; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D059906:Neuroimaging / Q000379:methods*; D012189:Retrospective Studies; D012851:Sinus Thrombosis, Intracranial / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology