Imaging Features Of Cerebral Venous Sinus Thrombosis

Purpose:Venous sinus thrombosis is a rare clinical cerebrovascular disease commonin young people, cerebral venous system becomes narrow or occlusion causedby a variety of causes. It is neurological disease characterized by CerebralVenous obstruction leading to intracranial pressure turn into high. We came tolearn about it from a case report more than10years ago. Not only we getting arelatively high leval of understanding the disease, but also the development anduniversal of imaging technique contributes to the CVST diagnosis. Wemisunderstood the real number of clinical cases as the pathogeny is complexand clinical manifestations is lack of specificity, so the real disease still lack ofepidemiological data. The majority of patients will be good prognosis exceptsome patients who with delay diagnosis and treatment will leave over serioussequel, even death. In order to increase the awareness of the disease weretrospectively selected CVST patients in our hospital, evaluated thecoincidence rate of the CT, MRI, MRV for venous sinus thrombosis and thediagnostic value for venous sinus thrombosis, summarized the experience inorder to reduce the misdiagnosis of intracranial venous sinus thrombosis.Materials and Methods:We collected32cases of CVST in our hospital from January2010toDecember2014in accordance with2011CVST guide diagnostic criteria. We gathered CVST patients’ imaging data of CT, MRI and MRV for statisticalanalysis. We try to observe the compliance rate of patients with thecorresponding period of the image changes to evaluate the diagnosticsensitivity of imaging according to statistics CT, MRI, MRV for CVST.We classified the cases for the norm in accordance with similar casefeatures and identical cerebral lesions. The cerebral intravenous lesions usuallyclassified into cavernous sinus thrombosis, superior sagittal sinus thrombosis,lateral sinus thrombosis.Results:There are32patients in this statistics, the male and female ratio is1:1.1,the average age is37.4, the average treatment period is6.3days; CVST resultsin an average hospital stay of23.2days. Acute CVST are22cases (72.5%),sub-acute CVST are six cases (17.2%), chronic CVST are4cases (10.3%).This group of patients who suffer from headache as the first symptom isthe13cases (40.6%), headache going along with nausea and vomiting is7cases (21.9%), dizziness is3patients (9.4%), headache going along with focalneurologic impairment is6cases (18.7%), headache going along with seizuresis8cases (25%),unresponsive is three cases (9.3%), inpairment of vision is1case (3.1%), 17cases of patients selected head CT as the preferred screening whichshows rate of28%direct signs appear, indirect signs appear34percent, bothsigns appear21%.32patients underwent MRI and MRV examination: There are16cases(54%) with two or more simultaneous sinus thrombosis,11cases (34%)with one sinus thrombosis.23cases of the transverse sinus (72%) including15cases of left transverse sinus and12cases of right transverse sinus,14cases ofsigmoid sinus(45%), including10cases of left sigmoid sinus,5cases of rightsigmoid sinus,7cases of superior sagittal sinus (23%),4cases of straightsinus (13%),5cases of sinus confluence(16%),5cases of inferior sagittal sinusin (16%),1case of cavernous sinus (2%).Patients suffered from acute CVST conduct MRI can be detected38%thrombus signal in T1WI,48%thrombus signal in T2WI, FLAIR sensitivitywas62.5%. MRV can detect86.3%, MRI+MRV can detect90.8%ofthrombus signal. T1WI can detect60%thrombus signal that CVST is subacutephase,T2WI can detect71.4%thrombus signal, the sensitivity of FLAIR andDWI is66%, MRV is85.7%, MRI+MRV can detect100%of thrombus signal.T1WI can detect66.6%thrombus signal of CVST in chronic phase, T2WI candetect66.6%thrombus signal, FLAIR and DWI sensitivity is66.6%, MRVup to100%, MRI+MRV can detect100%of thrombus signal. Conclusion:1．Acute CVST is more common, the sensitivity of FLAIR is62%, MRVis86%, the combination of MRI and MRV is90.8%.2．The symptoms of high intracranial pressure is the most common clinicalsymptoms; In male patients, the most common disease Pathogeny is infect, infemale patients, the most common disease because of pregnancy orpostpartum onset.3．The incidence rate of CVST：72%transverse sinus,45%sigmoid sinus,23%superior sagittal sinus.