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Bithalamic hyperintensity on T2-weighted MR: vascular causes and evaluation with MR angiography
D A Bell1, W L Davis, A G Osborn
1Department of Radiology, University of Utah School of Medicine, Salt Lake City.
AJNR. American Journal of Neuroradiology
|May 1, 1994
Summary
Magnetic resonance (MR) angiography can differentiate between top of the basilar artery occlusion and deep cerebral vein thrombosis, two causes of bithalamic hyperintensity on MR images. This imaging technique aids in diagnosing the specific vascular origin of these brain abnormalities.
Area of Science:
- Neuroimaging
- Vascular Neurology
- Radiology
Background:
- Bithalamic hyperintensity on T2-weighted MR images can stem from two distinct vascular conditions: top of the basilar artery occlusion and deep cerebral vein thrombosis.
- Differentiating these conditions is crucial for appropriate clinical management and treatment strategies.
Purpose of the Study:
- To evaluate the efficacy of MR angiography in distinguishing between arterial (top of the basilar artery occlusion) and venous (deep cerebral vein thrombosis) causes of bithalamic hyperintensity.
- To assess MR angiography as an adjunct to standard MR imaging for diagnosing vascular pathologies affecting the thalami.
Main Methods:
- Retrospective analysis of six patients presenting with bithalamic T2 hyperintensity of vascular etiology.
- Application of various MR angiography techniques, including 3D time-of-flight, 2D time-of-flight, and 2D phase-contrast.
- Correlation of imaging findings with clinical presentation and conventional angiography where available.
Main Results:
- MR angiography accurately identified the vascular source (arterial or venous) in all five cases where it was utilized.
- Three cases each of top of the basilar artery occlusion and deep cerebral vein thrombosis were diagnosed.
- Specific patterns of infarction were observed, aiding in the differentiation between arterial and venous occlusive events.
Conclusions:
- MR angiography is a valuable tool for differentiating between top of the basilar artery occlusion and deep cerebral vein thrombosis in patients with bithalamic T2 hyperintensity.
- The integration of MR angiography with MR imaging enhances diagnostic accuracy for these specific cerebrovascular conditions.