Identification and quantitative evaluation of symptomatic cerebral venous thrombosis using 3D variable flip angle...

Area of Science:

• Radiology and Imaging Science
• Neurology
• Vascular Medicine

Background:

• Cerebral venous thrombosis (CVT) is a challenging neurological condition requiring accurate and timely diagnosis.
• Conventional imaging techniques like contrast-enhanced magnetic resonance venography (CE-MRV) have limitations in diagnosing CVT.
• Exploring novel MRI sequences is crucial for improving diagnostic performance in suspected CVT cases.

Purpose of the Study:

• To evaluate the feasibility of using MR 3D T1w Sampling Perfection with Application optimized Contrasts by using different flip angle Evolutions (SPACE) sequence for diagnosing symptomatic CVT.
• To extract and quantitatively analyze imaging features from 3D T1w SPACE imaging for CVT diagnosis.
• To compare the diagnostic accuracy of 3D T1w SPACE imaging against CE-MRV.

Main Methods:

• Retrospective analysis of 59 patients with suspected CVT.
• Comparison of diagnostic accuracy between 3D T1w SPACE imaging and CE-MRV in 35 patients.
• Quantitative analysis of signal intensity and contrast enhancement (CE) rates in 45 patients with 101 involved CVT segments, categorized by clinical phase (acute, subacute, chronic) and pre-contrast T1WI signal characteristics.

Main Results:

• 3D T1w SPACE imaging achieved higher sensitivity and specificity (100%/94.1% patients, 100%/100% segments) than CE-MRV (73.9%/56.9% patients, 83.3%/98.9% segments).
• Quantitative analysis revealed significant differences in CE rates relative to reference tissues (pituitary gland, white matter, gray matter) across different clinical phases, particularly higher in chronic CVT.
• All quantitative parameters showed statistically significant differences across CVT segments of different imaging types (P≤0.001).

Conclusions:

• MR 3D T1w SPACE imaging is a feasible and highly accurate method for diagnosing CVT across various clinical stages.
• This advanced MRI technique enables precise identification of involved thrombus segments.
• 3D T1w SPACE imaging offers superior diagnostic performance compared to CE-MRV for CVT.