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Gadolinium-enhanced MR of chronic dural sinus thrombosis
1Department of Neuroradiology, Hôpital de la Pitiê-Salpêtrière, Paris, France.
Abstract:
Gadopentetate dimeglumine-enhanced MR imaging was performed in four patients with chronic dual sinus thrombosis. After injection, intense enhancement of the chronic thrombus was observed in all cases. On three-dimensional time-of-flight MR angiography, performed in one case, the occluded part of the superior sagittal sinus was not distinguishable from a normal sinus because of thrombus enhancement mimicking blood flow. Enhancement of the clot is best explained by organization of the thrombus, which is converted into vascularized connective tissue. It could lead to false-negative results in patients with chronic dural sinus thrombosis studied with contrast-enhanced MR or contrast-enhanced time-of-flight MR angiography techniques.
Insights
Gadopentetate dimeglumine-enhanced MR imaging can obscure chronic dural sinus thrombosis. Enhanced thrombus may mimic blood flow, potentially leading to false-negative results in diagnostic imaging.
Area of Science:
- Radiology and Medical Imaging
- Neurology
- Vascular Medicine
Background:
- Chronic dural sinus thrombosis presents diagnostic challenges.
- Gadolinium-based contrast agents are frequently used in Magnetic Resonance (MR) imaging.
- Understanding contrast enhancement patterns in chronic thrombi is crucial for accurate diagnosis.
Purpose of the Study:
- To evaluate the enhancement characteristics of chronic dual sinus thrombosis using gadopentetate dimeglumine-enhanced MR imaging.
- To assess the potential for misinterpretation of chronic thrombi as patent sinuses on enhanced MR angiography.
Main Methods:
- Retrospective analysis of four patients with chronic dual sinus thrombosis.
- Administration of gadopentetate dimeglumine contrast agent prior to MR imaging.
- Performance of three-dimensional time-of-flight MR angiography in one patient.
Main Results:
- Intense enhancement of chronic thrombi was observed in all four patients post-contrast injection.
- In one case, enhanced thrombus in the superior sagittal sinus mimicked normal blood flow on MR angiography, obscuring the occlusion.
- This enhancement is attributed to the vascularized connective tissue within organized thrombi.
Conclusions:
- Gadopentetate dimeglumine enhancement of chronic dural sinus thrombi can lead to diagnostic errors.
- Contrast-enhanced MR imaging and MR angiography may yield false-negative results for chronic sinus thrombosis.
- Radiologists must be aware of this enhancement phenomenon to avoid misdiagnosis.