The Study Of MR Diffusion Weighted Imaging In Brain Damage With Cerebral Venous Sinus Thrombosis (CVST)

ObjectiveTo evaluate the application and clinical value of MR diffusion-weighted imaging (DWI) in brain parenchyma changes of cerebral venous sinus thrombosis (CVST).Methods(1) 16 cases with CVST, whose proved by clinical and MR imaging, were analyzed of the manifestation on conventional MRI, DWI and magnetic resonance venography (MRV). Findings of CVST on MRI were divided into 4 groups:(1) no abnormal signal on T2WI and DWI. (2) high signal intensity on T2WI and DWI. (3) high signal intensity only on T2WI. (4) hemorrhage signal (low signal intensity on T2WI, DWI and high signal intensity on T1WI). The mean ADC values of 4 groups were calculated and were compared with signal intensity of contralateral normal-appearing brain.(2) 20 cases with acute arterial infarction were performed with both conventional MRI and DWI. The ADC values from the center to the periphery of the lesion were calculated. The high signal intensity both on DWI and T2WI were located at the periphery of the lesion and were disappeared on follow-up MR images. The central of the lesion showed high signal on T2WI and persisted in follow-up MR images. The two region of ADC values were measured and were compared.Results(1) The brain parenchyma changes on conventional MRI and DWI were found in 13 cases.11 cases were hemorrhagic infarction and 2 cases were ischemic infarction. The unchanged signal intensity on DWI and MRI were found in 3 cases, the high signal intensity both on T2WI and DWI in 10 cases, the high signal intensity only on T2WI in 8 cases, hemorrhage signal intensity in 11 cases. DWI was more sensitive than T2WI and T1WI in finding cerebral hemorrhage. T2WI was a sensitive method in detecting ischemic edema of CVST(2) The mean ADC values was no obvious difference between 3 cases with unchanged signal intensity and contralateral normal-appearing brain on T2WI and DWI (p>0.05). The mean ADC values of the high signal intensity both on T2WI and DWI was lower than normal brain parenchyma (p<0.05). The mean ADC values of high signal intensity only on T2WI were higher than contralateral normal-appearing brain (p<0.05). The mean ADC values of the hematomas were lower than contralateral normal-appearing brain (p<0.05).(3) The mean ADC values from the center to the periphery of the lesion of arterial infarction in follow-up MR images were significantly higher than those of the acute infarction lesion (p<0.05). The mean ADC values of periphery of the lesion (high intensity on T2WI) were higher than the center in follow-up MR images.(4) There was no significant difference between the ADC values of the brain parenchyma changes (high signal intensity both on T2WI and DWI) with CVST and the center to the periphery of the lesion of acute arterial stroke. There was significant difference between the ADC values of the brain parenchyma changes (high signal intensity only on T2WI) with CVST and the center to the periphery of the lesion of infarction lesion of acute arterial stroke.Conclusion(1) These data suggest that findings of the brain parenchyma changes of CVST on conventional MRI and DWI mainly were hemorrhage and ischemic edema. The conventional MRI and DWI can provide information about brain parenchyma pathophysiological phase in CSVT.(2)There was significant difference between the ADC values of the brain parenchyma signal changes of and contralateral, normal-appearing brain of CVST. The ADC values in brain parenchyma change with CVST were more complicated and were related to a number of factors. The ADC values could not predict the severity of brain damage with CVST.The mechanism of brain damage with CVST is worth studying further.(3) The brain damage with CVST and arterial stroke were significantly different in lesion site, time of diagnosis, lesion progress, medical imaging manifestation and ADC values.