Dural sinus occlusion: evaluation with phase-sensitive gradient-echo MR imaging.

The purpose of this study was to evaluate the usefulness of limited-flip-angle, phase-sensitive velocity imaging with gradient-recalled-echo (VIGRE) MR when combined with spin-echo MR in the diagnosis of dural sinus thrombosis. The VIGRE sequence consists of a rapid single-slice acquisition, 50/15/2 (TR/TE/excitations), and 30 degrees flip angle. At each slice position, a total of four images were reconstructed; these consisted of one magnitude image and three images sensitive to proton motion in each orthogonal direction. The flow direction and flow velocity (cm/sec) were obtained from each of the phase images, and results were correlated with data obtained from a phantom experiment. In normal controls, dural sinus velocities ranged from a mean of 9.9 to 14.4 cm/sec for the transverse and superior sagittal sinuses, respectively. Three patients with proved dural sinus occlusion were studied with spin-echo images at 1.5 T. Three-dimensional time-of-flight MR angiography was also performed in one patient. The presence of dural sinus occlusion was determined by the lack of flow void on the spin-echo images, the absence of phase shift on the VIGRE study, and the presence of retrograde flow on the phase image in the sinus proximal to the occluded segment. Time-of-flight angiography overestimated the extent of the thrombosis caused by spin saturation. Follow-up VIGRE studies detected the formation of collateral flow in one patient and recanalization with the establishment of normal antegrade sinus flow in the other. We conclude that phase-sensitive MR imaging is helpful in establishing the diagnosis and extent of dural sinus occlusion.(ABSTRACT TRUNCATED AT 250 WORDS)