Open AccessWhole-Brain Computed Tomographic Perfusion Imaging in Acute Cerebral Venous Sinus Thrombosis
Author(s) -
Maxim Mokin,
Chelsey C Ciambella,
Muhammad W Masud,
Elad I. Levy,
Kenneth V. Snyder,
Adnan H. Siddiqui
Publication year - 2015
Publication title -
interventional neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.07
H-Index - 5
eISSN - 1664-9737
pISSN - 1664-5545
DOI - 10.1159/000442717
Subject(s) - medicine , perfusion scanning , computed tomographic , venous thrombosis , radiology , thrombosis , intracranial thrombosis , cardiology , perfusion , computed tomography
Background: Acute cerebral venous sinus thrombosis (VST) can be difficult to diagnose because of its diverse clinical presentation. The utility of perfusion imaging for diagnosing VST is not well understood. Summary: We retrospectively reviewed cases of acute VST in patients who underwent whole-brain (320-detector-row) computed tomographic (CT) perfusion imaging in combination with craniocervical CT venography. Perfusion maps that were analyzed included cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time, and time to peak. Among the 10 patients with acute VST included in this study, 9 had perfusion abnormalities. All perfusion abnormalities were localized in areas adjacent to the occluded sinus and did not match typical anterior or posterior circulation arterial territories. Bilateral perfusion deficits were seen in 4 cases. In 2 cases, parenchymal hemorrhage was diagnosed on noncontrast CT imaging; in those cases, focal CBV and CBF were reduced. Key Messages: Whole-brain CT perfusion imaging with 320-detector-row scanners can further assist in establishing the diagnosis of VST by detecting perfusion abnormalities corresponding to venous and not arterial territories. CT perfusion could assist in the differentiation between focal reversible changes, such as those caused by vasogenic edema, and irreversible changes due to infarction.