Magnetic resonance thrombus imaging for the differentiation of chronic versus (sub)acute cerebral vein thrombosis: A case report

Abstract

The diagnosis of cerebral vein thrombosis (CVT) can be difficult. Patients with suspected CVT, in whom venous sinuses are affected by intracranial tumours or after intracranial surgery constitutes a particular challenging setting. Magnetic resonance non-contrast thrombus imaging (MR-NCTI) is a new magnetic resonance imaging (MRI) technique that has previously been shown to be accurate in the diagnosis of a first CVT and difficult-to-diagnose venous thrombosis in other anatomical locations. In this case report, a patient with a medical history of craniotomy for parieto-occipital meningioma was suspected of an acute CVT, but had an inconclusive computed tomography (CT) and MRI venography. MR-NCTI showed no abnormalities diagnostic for (sub)acute CVT and thus cerebral sinus occlusion was most likely a chronic thrombus or a result of residual meningioma tissue. Anticoagulant treatment was discontinued and she was discharged from hospital in good health. This case shows that MR-NCTI may be a valuable additional imaging test in complex cases in whom CT and MRI venography could not exclude acute CVT.

Keywords

• Venous thrombosis
• Sinus thrombosis
• Diagnosis
• Diagnostic imaging
• Magnetic resonance imaging