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Pearls and Pitfalls in the Magnetic Resonance Diagnosis of Dural Sinus Thrombosis: A Comprehensive Guide for the Trainee Radiologist

Authors
  • Pai, Vivek1
  • Khan, Iram1
  • Sitoh, Yih Yian1
  • Purohit, Bela1
  • 1 Department of Neuroradiology, National Neuroscience Institute , (Singapore)
Type
Published Article
Journal
Journal of Clinical Imaging Science
Publisher
Scientific Scholar
Publication Date
Nov 28, 2020
Volume
10
Identifiers
DOI: 10.25259/JCIS_187_2020
PMID: 33365199
PMCID: PMC7749941
Source
PubMed Central
Keywords
Disciplines
  • Review Article
License
Green

Abstract

Dural sinus thrombosis (DST) is a potentially fatal neurological condition that can be reversed with early diagnosis and prompt treatment. Non-enhanced CT scan is often the first imaging investigation in patients presenting with acute neurological symptoms; however, its poor sensitivity in detecting DST is a major drawback. Magnetic resonance (MR) imaging offers multiple advantages such as excellent contrast resolution and unenhanced venography possibilities, making it the mainstay in the non-invasive diagnosis of DST. However, physiological variations, evolution of thrombi, and incorrect selection/application of MR techniques can lead to false positive and false negative interpretations impacting patient management and outcome. This article discusses the MR techniques useful to diagnose DST and describes pitfalls, with troubleshooting methods, to ensure an accurate diagnosis. We have used multiple diagrammatic illustrations and MR images to highlight pertinent take-home points and to serve as an easy guide for day-to-day clinical practice.

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