Department of Imaging and Biophysics, Amiens University Hospital, 80054 Amiens Cedex France, Department of Neurology, Cliniques Universitaires Saint-Luc, Brussels, Belgium, Department of Clinical Neurosciences, Academic Neurosurgical Unit, University of Cambridge, Addenbrooke’s Hospital, Box 167 Cambridge, United Kingdom, Department of Radiology, Amiens University Hospital, 80054 Amiens Cedex France
Date of Submission: 31-Mar-2012, Date of Acceptance: 13-Apr-2012, Date of Web Publication: 28-Jul-2012.
Background and Purpose: Recent studies of the organization of the cerebral venous system in healthy subjects using phase contrast magnetic resonance imaging (PCMRI) show its structural complexity and inter-individual variations. Our objective was to study the venous blood and CSF flows in cerebral venous thrombosis (CVT). Materials and Methods: PC-MRI sequences were added to brain MRI conventional protocol in 19 patients suspected of CVT, among whom 6 patients had CVT diagnosis confirmed by MR venography. Results were compared with 18 healthy age-matched volunteers (HV). Results: In patients without CVT (NoCVT) confirmed by venography, we found heterogeneous individual venous flows, and variable side dominance in paired veins and sinuses, comparable to those in healthy volunteers. In CVT patients, PC-MRI detected no venous flow in the veins and/or sinuses with thrombosis. Arterial flows were preserved. CSF aqueductal and cervical stroke volumes were increased in a patient with secondary cerebral infarction, and decreased in 4 patients with extended thrombosis in the superior sagittal and transverse sinuses. These results suggest the main role of the venous system in the regulation of the dynamic intracranial equilibrium. Conclusions: CVT produces highly individualized pattern of disturbance in venous blood drainage. Complementary to MRI venography, PC-MRI provides non-invasive data about venous blockage consequences on CSF flow disturbances.
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