This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Keller, E. Articles by Schild, H. H. Search for Related Content PubMed PubMed Citation Articles by Keller, E. Articles by Schild, H. H. Pubmed/NCBI databases Medline Plus Health Information MRI Scans Related Collections Cerebral Venous Thrombosis Computerized tomography and Magnetic Resonance Imaging

(Stroke. 1999;30:1144-1146.)
© 1999 American Heart Association, Inc.

Case Reports

Diffusion- and Perfusion-Weighted Magnetic Resonance Imaging in Deep Cerebral Venous Thrombosis

Ewald Keller, MD; Sebastian Flacke, MD; Horst Urbach, MD Hans H. Schild, MD

From the Department of Radiology, University of Bonn, Germany.

Correspondence to Ewald Keller, MD, Radiologische Universitätsklinik Bonn, Sigmund-Freud-Str 25, D-53105 Bonn, Germany.

Abstract

Background—Diffusion-weighted (DWI) and perfusion-weighted (PI) MRI are highly sensitive techniques for early diagnosis of arterial infarction, but little data on venous cerebral ischemia are available. We describe a case in which DWI, PI, and fast T2–weighted sequences were performed in the acute phase of deep cerebral venous thrombosis (CVT).

Case Description—An 11-year-old girl with Crohn's disease developed deep CVT in which extensive edema was shown in the deep gray matter on T2-weighted sequence images. Isotropic echo-planar DWI demonstrated a local augmentation of the apparent diffusion coefficient (1.1 to 1.6x10^-3 mm²/s), consistent with vasogenic edema. In dynamic contrast–enhanced PI, the regional cerebral blood volume was increased and the passage time of the contrast bolus was markedly prolonged. Clinically, the patient recovered totally after intravenous full-dose heparinization. T2 abnormalities, apparent diffusion coefficient values (0.8 to 0.92x10^-3 mm²/s), and brain perfusion alterations resolved without damage to brain tissue.

Conclusions—Unlike arterial infarction, DWI demonstrated vasogenic edema in a patient with deep CVT, which proved to be reversible in follow-up magnetic resonance imaging. PI showed areas with extensive venous congestion, but perfusion deficits were missing. Therefore, we believe that DWI and PI may play a role in detecting venous congestion in CVT and in prospective differentiation of vasogenic edema and venous infarction.

Key Words: cerebral veins • diagnosis • diffusion • magnetic resonance imaging • perfusion • thrombosis

This article has been cited by other articles:

				J. Linn, T. Pfefferkorn, K. Ivanicova, S. Muller-Schunk, S. Hartz, M. Wiesmann, M. Dichgans, and H. Bruckmann Noncontrast CT in Deep Cerebral Venous Thrombosis and Sinus Thrombosis: Comparison of its Diagnostic Value for Both Entities AJNR Am. J. Neuroradiol., April 1, 2009; 30(4): 728 - 735. [Abstract] [Full Text] [PDF]

				N. S. Abend, R. Ichord, Aijun Zhang, and R. Hurst Vein of Galen Aneurysmal Malformation With Deep Venous Communication and Subarachnoid Hemorrhage J Child Neurol, April 1, 2008; 23(4): 441 - 446. [Abstract] [PDF]

				J. L. Leach, R. B. Fortuna, B. V. Jones, and M. F. Gaskill-Shipley Imaging of Cerebral Venous Thrombosis: Current Techniques, Spectrum of Findings, and Diagnostic Pitfalls RadioGraphics, October 1, 2006; 26(suppl_1): S19 - S41. [Abstract] [Full Text] [PDF]

				W. M. van den Bergh, I. van der Schaaf, and J. van Gijn The spectrum of presentations of venous infarction caused by deep cerebral vein thrombosis Neurology, July 26, 2005; 65(2): 192 - 196. [Abstract] [Full Text] [PDF]

				T. W. Stadnik, P. Demaerel, R. R Luypaert, C. Chaskis, K. L. Van Rompaey, A. Michotte, and M. J. Osteaux Imaging Tutorial: Differential Diagnosis of Bright Lesions on Diffusion-weighted MR Images RadioGraphics, January 1, 2003; 23(1): e7 - e7. [Abstract] [Full Text]

				E. Peeters, T. Stadnik, F. Bissay, E. Schmedding, and M. Osteaux Diffusion-Weighted MR Imaging of an Acute Venous Stroke: Case Report AJNR Am. J. Neuroradiol., November 1, 2001; 22(10): 1949 - 1952. [Abstract] [Full Text] [PDF]

				K. Chu, D.-W. Kang, B.-W. Yoon, and J.-K. Roh Diffusion-Weighted Magnetic Resonance in Cerebral Venous Thrombosis Arch Neurol, October 1, 2001; 58(10): 1569 - 1576. [Abstract] [Full Text] [PDF]

				D. Ducreux, C. Oppenheim, X. Vandamme, D. Dormont, Y. Samson, G. Rancurel, G. Cosnard, and C. Marsault Diffusion-weighted Imaging Patterns of Brain Damage Associated with Cerebral Venous Thrombosis AJNR Am. J. Neuroradiol., February 1, 2001; 22(2): 261 - 268. [Abstract] [Full Text] [PDF]

				J. M. Provenzale CT and MR Imaging of Nontraumatic Neurologic Emergencies Am. J. Roentgenol., February 1, 2000; 174(2): 289 - 299. [Full Text] [PDF]