Neuroimaging findings in pediatric cerebral sinovenous thrombosis

Matthias W. Wagner, Thangamadhan Bosemani, Alexander Oshmyansky, Andrea Poretti, Thierry A.G.M. Huisman

Research output: Contribution to journalArticle

Abstract

Purpose: Pediatric cerebral sinovenous thrombosis (CSVT) is a potentially life-threatening condition which is usually diagnosed by MRI. We analyzed the signal changes of the thrombus over time and the role of diffusion-weighted/tensor imaging (DWI/DTI) in the diagnosis of CSVT.Methods: Clinical histories were reviewed for risk factors for CSVT, neurologic manifestation, and interval from onset of symptoms related to CSVT to the neuroimaging diagnosis. MRI studies were retrospectively evaluated for the appearance of thrombi on T1- and T2-weighted, fluid-attenuated inversion recovery (FLAIR), DWI/DTI, susceptibility-weighted imaging (SWI), and magnetic resonance venography (MRV) images.Results: Thirty-three children with CSVT were included in this study. Seventy-seven thrombi were found. Seventy-four thrombi could be identified on T1- or T2-weighted images (96 %), 72 thrombi were seen on DWI/DTI (94 %) and 68 on FLAIR (88 %). DWI showed restricted diffusion in 29 thrombi (40 %). Thrombi older than 1 day were more likely to have a T1-hyperintense signal (p = 0.002). No additional correlation between signal intensity and age of the thrombi was found. Intraparenchymal changes secondary to CSVT were seen in 11 children.Conclusion: MR sequences individually are not sensitive enough to provide the diagnosis. DWI/DTI does not provide complementary diagnostic value. Approximation of the age of the thrombus is difficult because of poor correlation between signal intensity and age of the thrombi.

Original languageEnglish (US)
Pages (from-to)705-712
Number of pages8
JournalChild's Nervous System
Volume31
Issue number5
DOIs
StatePublished - May 1 2015

Keywords

  • Children
  • Diffusion-weighted imaging
  • Neuroimaging
  • Sinovenous thrombosis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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    Wagner, M. W., Bosemani, T., Oshmyansky, A., Poretti, A., & Huisman, T. A. G. M. (2015). Neuroimaging findings in pediatric cerebral sinovenous thrombosis. Child's Nervous System, 31(5), 705-712. https://doi.org/10.1007/s00381-015-2662-1