Value Of DWI In The Diagnosis Of Cerebral Venous And Sinus Thrombosis

Objective:In patients with cerebral venous and sinus thrombosis(CVST), hyperintensity signal in site of thrombosed sinus can been seen on diffusion weighted imaging(DWI). This study was aimed to explore the evolution of clot on DWI and evaluated the role of DWI in detecting CVST.Methods:Patients with CVST admitted to our department from January 2004 to December 2015 were retrospectively collected. Sex and age matched people without intracranial organic diseases were included as control group. Patients’ data were collected and their risk factors of CVST were determined. BrainT1/T2 weighted imaging (T1/T2)WI) and digital subtraction angiography(DSA) and/or magnetic resonance venography (MRV) and/or computed tomography venography(CTV) were used as the gold standard to determine site of thrombosis, the sensitivity of DWI,T1/T2 WI and DWI plus T1/T2 WI in detecting CVST were calculated. The specificity of DWI,T1/T2 WI i DWI plus T1/T2 WI in detecting CVST were determined according the results of DWI and T1/T2 WI in control group.Results:1. Thrombosis most commonly occurred in transverse sinus thrombosis, followed by the superior sagittal sinus, sigmoid sinus, jugular vein and straight sinus. Thrombosis in the right transverse sinus, sigmoid sinus and right internal jugular vein was more common than that in their left counterparts.2. T1/T2 WI was more sensitive in detecting CVST than DWI. The sensitivity of DWI plus T1/T2 WI in detecting CVST was similar to that of T1/T2 DWI alone.3. DWI turned out to be less sensitive in detecting CVST than T1/T2WI in all but straight sinus and bilateral internal jugular vein.4. Sensitivity of DWI performed 31 days after onset in detecting CVST was lower than that performed in 30 days after onset.5. Hyperintensity signal in site of cerebral venous sinus on DWI was not detected in control group.Conclusion:Clot in cerebral venous sinus can manifested itself as hyperintensity signal on DWI. DWI is less sensitive to detect CVST than T1/T2 WI does. Compared with T1/T2 WI, DWI+T1/T2 WI dose not increase the sensitivity in detecting CVST. However, Hyperintensity signal on DWI is of high specificity for the diagnosis of CVST.