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Imaging of Cerebral Venous Thrombosis: Current Techniques, Spectrum of Findings, and Diagnostic Pitfalls¹

¹ From the Department of Radiology, University of Cincinnati College of Medicine, 234 Goodman St, Cincinnati, OH 45246 (J.L.L., R.B.F., M.F.G.S.); the Neuroscience Institute, Cincinnati, Ohio (J.L.L., M.F.G.S.); and Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio (B.V.J.). Recipient of a Cum Laude award for an education exhibit at the 2004 RSNA Annual Meeting. Received September 19, 2005; revision requested January 13, 2006 and received February 17; accepted April 6. All authors have no financial relationships to disclose. Address correspondence to J.L.L. (e-mail: james.leach{at}uc.edu).

Cerebral venous thrombosis is a relatively uncommon but serious neurologic disorder that is potentially reversible with prompt diagnosis and appropriate medical care. Because the possible causal factors and clinical manifestations of this disorder are many and varied, imaging plays a primary role in the diagnosis. Magnetic resonance (MR) imaging, un-enhanced computed tomography (CT), unenhanced time-of-flight MR venography, and contrast material–enhanced MR venography and CT venography are particularly useful techniques for detecting cerebral venous and brain parenchymal changes that may be related to thrombosis. To achieve an accurate diagnosis, it is important to have a detailed knowledge of the normal venous anatomy and variants, the spectrum of findings (venous sinus thrombi and recanalization, parenchymal diffusion or perfusion changes or hemorrhage), other potentially relevant conditions (deep venous occlusion, isolated cortical venous thrombosis, idiopathic intracranial hypertension), and potential pitfalls in image interpretation.

© RSNA, 2006

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