Evaluation of Magnetic Resonance Venography Techniques on the Detection of Dural Sinus Variations, Flow Gaps, and Thrombosis

INTRODUCTION: The aim of the study was to examine the role of the contrast-enhanced gadolinium-enhanced three-dimensional magnetic resonance venography (GE 3D MRV) technique in the detection of dural sinus pathologies by comparing the two-dimensional (2D TOF MRV).
METHODS: One hundred and eighty patients who underwent MRV due to dural sinus pathology in the radiology department of Haydarpaşa Numune Training and Research Hospital between January 2019 and July 2019 were included in the study. Images of 21 patients in the study group who had both 2D TOF MRV or GE 3D MRV were evaluated retrospectively.
RESULTS: About 33.3% of cases were male and 66.7% (n=14) were female. The mean age of the patients was 29.7±4.64 years (18–64 years). In 2D TOF MRV series, complete signal loss was observed in the unilateral transverse sinus (TS) of four patients (2.2%/180–1.6%) and in the sinus rectus of 1 patient (1/180–0.55%). Of these, 2 (1.1%) located in the TS and GE (2.1%) located in the sinus rectus were confirmed in the 3D MRV. Two patients’ imaging showed a jugular vein and ipsilateral sigmoid sinus flow defect on 2D TOF MRV, but no findings on GE 3D MRV. There were four arachnoid granulations observed in the transverse sinuses in 4% of cases on two-dimensional venography, all of them confirmed on contrast-enhanced examinations. Six of the flow gaps observed in the transverse sinuses of 12 patients in 2D TOF MRV, disappeared completely in GE 3D MRV. When the diameters of the transverse sinuses were determined using the two techniques, the ratio of inconsistencies in Grade 0 and Grade 3 was higher than the others.
DISCUSSION AND CONCLUSION: GE 3D MRV, a contrast imaging method, can be used effectively when there is a diagnostic challenge to exclude sinus thrombosis on 2D TOF imaging.