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Gadolinium-DTPA enhanced MR imaging of septic dural sinus thrombosis
T M Harris1, R R Smith, K J Koch
1Department of Radiology, Indiana University Medical Center, Indianapolis 46223.
Abstract:
We present a case of septic transverse/sigmoid sinus thrombosis imaged with gadopentetate dimeglumine enhanced magnetic resonance (MR). The appearance of the septic thrombus was atypical and did not conform to the usual blood degradation products probably because of the septic nature of the process. Enhanced T1-weighted images demonstrate both the "delta" sign and the tentorial enhancement as previously seen with contrast enhanced CT. Surgical correlation was obtained and helps to account for the appearance of the clot on MR.
Insights
Septic transverse/sigmoid sinus thrombosis can have an unusual appearance on magnetic resonance (MR) imaging due to infection. Enhanced T1-weighted MR images revealed characteristic signs like the "delta" sign and tentorial enhancement.
Area of Science:
- Neurology
- Radiology
- Infectious Diseases
Background:
- Septic dural venous sinus thrombosis is a rare but serious condition.
- Typical magnetic resonance (MR) imaging findings may be altered by the infectious process.
Observation:
- A case of septic transverse/sigmoid sinus thrombosis is presented.
- Imaging was performed using gadolinium-enhanced magnetic resonance (MR).
Findings:
- The septic thrombus exhibited an atypical appearance, differing from expected blood degradation products.
- Enhanced T1-weighted MR images showed the "delta" sign and tentorial enhancement.
- Surgical correlation aided in understanding the MR imaging characteristics of the clot.
Implications:
- This case highlights the importance of considering atypical presentations in septic sinus thrombosis.
- Enhanced MR imaging can reveal specific signs useful for diagnosis.
- Understanding these imaging features is crucial for appropriate clinical management.