Matthias W Wagner1, Thangamadhan Bosemani, Alexander Oshmyansky, Andrea Poretti, Thierry A G M Huisman. 1. 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.
Abstract
PURPOSE: 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. CONCLUSION: 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.
PURPOSE: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. CONCLUSION: 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: G deVeber; M Andrew; C Adams; B Bjornson; F Booth; D J Buckley; C S Camfield; M David; P Humphreys; P Langevin; E A MacDonald; J Gillett; B Meaney; M Shevell; D B Sinclair; J Yager Journal: N Engl J Med Date: 2001-08-09 Impact factor: 91.245
Authors: E Steve Roach; Meredith R Golomb; Robert Adams; Jose Biller; Stephen Daniels; Gabrielle Deveber; Donna Ferriero; Blaise V Jones; Fenella J Kirkham; R Michael Scott; Edward R Smith Journal: Stroke Date: 2008-07-17 Impact factor: 7.914
Authors: Andrea Romano; Maria Camilla Rossi-Espagnet; Luca Pasquini; Alberto Di Napoli; Francesco Dellepiane; Giulia Butera; Giulia Moltoni; Olga Gagliardo; Alessandro Bozzao Journal: Tomography Date: 2021-12-22