Arterial Spin Labelling Magnetic Resonance Perfusion Imaging for the Diagnosis of Acute Cerebral Venous Thrombosis
Öz
Abstract
Background: Early diagnosis of cerebral venous thrombosis (CVT) is crucial for a favourable prognosis as CVT can lead to severe outcomes. However, certain scenarios, such as during pregnancy, restrict the use of contrast agents, thus rendering conventional magnetic resonance imaging (MRI) methods insufficient for accurate diagnosis. In light of these challenges, our study endeavours to assess the diagnostic potential of the arterial spin labelling magnetic resonance perfusion (ASL-MRP) technique, a contrast-agent–free approach, in the context of CVT diagnosis.
Materials and Methods: Between 1 March 2022 and 30 May 2022, patients diagnosed with CVT via contrast-enhanced MR venography in the neurology clinic of our hospital were evaluated through ASL-MRP. Patient-specific demographics, including age, gender, presenting symptoms, underlying causes, impacted cortical sinus structures and MRI findings, were documented. Within the framework of ASL-MRP, an elevation in cerebral blood flow (CBF) detected within the affected sinus and/or neighbouring structures was deemed indicative of pathological conditions.
Results: Among the 13 patients included in our study, six were diagnosed with acute CVT, whereas seven were diagnosed with chronic CVT. The assessment of CBF using ASL-MRP revealed CBF elevation in five out of the six cases (83.3%) exhibiting acute CVT. However, no anomalous findings were observed in the ASL-MRP scans of patients presenting with chronic CVT.
Discussion: The utilisation of ASL-MRP eliminates the need for contrast agent administration. It is a promising technique in facilitating the diagnosis of acute CVT and distinguishing it from chronic CVT cases.
Anahtar Kelimeler
Cerebral venous thrombosis arterial spin labelling magnetic resonance perfusion pregnancy diagnosis
Kaynakça
- 1. Bousser M-G, Ferro JM. Cerebral venous thrombosis: an update. Lancet Neurol. 2007;6:162–70.
- 2. Haghighi AB, Edgell RC, Cruz-Flores S, et al. Mortality of cerebral venous–sinus thrombosis in a large national sample. Stroke. 2012;43(1):262-264.
- 3. Preter M, Tzourio C, Ameri A, Bousser MG. Long-term prognosis in cerebral venous thrombosis: follow-up of 77 patients. Stroke. 1996;27(2):243-246.
- 4. Chiewvit P, Piyapittayanan S, Poungvarin N. Cerebral venous thrombosis: diagnosis dilemma. Neurology international. 2011;3(3):e13.
- 5. Tanislav C, Siekmann R, Sieweke N, et al. Cerebral vein thrombosis: clinical manifestation and diagnosis. BMC neurology. 2011;11(1):1-5.
- 6. Li Y, Zhang M, Xue M, Wei M, He J, Dong C. A case report of cerebral venous sinus thrombosis presenting with rapidly progressive dementia. Frontiers in Medicine. 2022;9:985361.
- 7. Ferro JM, Bousser MG, Canhão P, et al. European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis–endorsed by the European of Neurology. ESJ. 2017;2(3):195-221.
- 8. Garvey CJ, Hanlon R. Computed tomography in clinical practice. BMJ. 2002;324(7345):1077-1080.
- 9. Yiğit H, Turan A, Ergün E, Koşar P, Koşar U. Time-resolved MR angiography of the intracranial venous system: an alternative MR venography technique. ER. 2012;22:980-989.
- 10. Ghoneim A, Straiton J, Pollard C, Macdonald K, Jampana R. Imaging of cerebral venous thrombosis. Clinical radiology. 2020;75(4):254-264.
- 11. van Dam LF, van Walderveen MA, Kroft LJ, et al. Current imaging modalities for diagnosing cerebral vein thrombosis–A critical review. Thrombosis research. 2020;189:132-139.
- 12. Sadik JC, Jianu DC, Sadik R, Purcell Y, et al. Imaging of Cerebral Venous Thrombosis. Life. 2022;12(8):1215.
- 13. Petcharunpaisan S, Ramalho J, Castillo M. Arterial spin labeling in neuroimaging. WJR. 2010;2(10):384.
- 14. Chen J, Licht DJ, Smith SE, Agner SC, et al. Arterial spin labeling perfusion MRI in pediatric arterial ischemic stroke: initial experiences. JMRI. 2009;29(2):282-290.
- 15. Bokkers RP, Hernandez DA, Merino JG, Mirasol RV, et al. Whole-brain arterial spin labeling perfusion MRI in patients with acute stroke. Stroke. 2012;43(5):1290-1294.
- 16. Kang JH, Yun TJ, Yoo RE, Yoon BW et al. Bright sinus appearance on arterial spin labeling MR imaging aids to identify cerebral venous thrombosis. Medicine. 2017;96(41):e8244.
- 17. Sassi SB, Touati N, Baccouche H, Drissi C, Romdhane NB, Hentati F. Cerebral venous thrombosis: a Tunisian monocenter study on 160 patients. Clin. Appl. Thromb. Hemost. 2016;23:1005–1009.
- 18. Coutinho JM, Zuurbier SM, Aramideh M, Stam J. The incidence of cerebral venous thrombosis: a cross-sectional study. Stroke. 2012;43:3375–3377.
- 19. Devasagayam S, Wyatt B, Leyden J, Kleinig T. Cerebral venous sinus thrombosis incidence is higher than previously thought: a retrospective population-based study. Stroke. 2016;47:2180–2182.
- 20. Capecchi M, Abbattista M, Martinelli I. Cerebral venous sinus thrombosis. JTH. 2018;16(10):1918-1931.
- 21. Coutinho JM, Ferro JM, Canhão P, et al. Cerebral venous and sinus thrombosis in women. Stroke. 2019;40(7):2356-2361.
- 22. Copel J, El-Sayed Y, Heine RP, Wharton KR. Guidelines for diagnostic imaging during pregnancy and lactation. Obstetrıcs and Gynecology. 2016;127(2):E75-E80.
- 23. Idbaih A, Boukobza M, Crassard I, Porcher R, Bousser MG, Chabriat H. MRI of clot in cerebral venous thrombosis: high diagnostic value of susceptibility-weighted images. Stroke. 2006;37(4):991-995.
- 24. Lv B, Tian C, Cao X, Liu X, Wang J, Yu S. Role of diffusion-weighted imaging in the diagnosis of cerebral venous thrombosis. JIMR. 2020;48(6):0300060520933448.
- 25. Kwon H, Choi DS, Jang J. Susceptibility-Weighted MR Imaging for the Detection of Isolated Cortical Vein Thrombosis in a Patient with Spontaneous Intracranial Hypotension. IMRI. 2019;23(4):381-384.
- 26. Sabet S, Gürcan NI. Perfüzyon MR Görüntüleme. Türk Radyoloji Seminerleri. 2020;pp:252-258.
Akut Serebral Venöz Tromboz Tanısında Arteriyel Spin Etiketleme Manyetik Rezonans Perfüzyon Görüntüleme
Öz
Öz
Amaç: Serebral venöz trombozunun (SVT) erken tanısı, SVT'nin ciddi sonuçlara yol açabilmesi nedeniyle iyi prognoz için çok önemlidir. Ancak hamilelik gibi bazı durumlar, kontrast maddelerin kullanımını kısıtlar, bu nedenle de geleneksel manyetik rezonans görüntüleme (MRG) yöntemleri doğru teşhis için yetersiz kalabilir. Bu zorluklar göz önünde bulundurularak çalışmamız, kontrast madde içermeyen bir yaklaşım olan arteriyel spin etiketleme tabanlı manyetik rezonans perfüzyon (ASE-MRP) tekniğinin, SVT teşhis potansiyelini değerlendirmeyi amaçlamaktadır.
Gereç ve Yöntem: 1 Mart 2022 ile 30 Mayıs 2022 tarihleri arasında hastanemiz nöroloji kliniğinde MR venografi ile SVT tanısı konulan hastalar ASE-MRP ile değerlendirildi. Yaş, cinsiyet, başvuru semptomları, risk faktörleri, etkilenen kortikal sinüs yapıları ve MRG bulguları kaydedildi. ASE-MRP tekniğinde, etkilenen sinüs ve/veya komşu yapılardaki serebral kan akımında (SKA) artış, patolojik durumların göstergesi olarak kabul edildi.
Bulgular: Çalışmamıza dahil edilen 13 hastanın altısına akut, yedisine kronik SVT teşhisi kondu. ASL-MRP kullanarak yapılan SKA değerlendirmesinde, akut SVT tanısı alan altı olgudan beşinde (%83,3) SKA artışı saptandı. Ancak kronik SVT ile başvuran hastaların ASL-MRP taramalarında anormal bulgu gözlenmedi.
Tartışma: ASL-MRP'nin kullanılması kontrast madde uygulama ihtiyacını ortadan kaldırır. Akut SVT'nin tanısını kolaylaştırmada ve kronik SVT vakalarından ayırmada umut verici bir tekniktir.
Anahtar Kelimeler
Serebral venöz tromboz gebelik tanı arteriyel spin etiketleme manyetik rezonans perfüzyon görüntüleme
Kaynakça
- 1. Bousser M-G, Ferro JM. Cerebral venous thrombosis: an update. Lancet Neurol. 2007;6:162–70.
- 2. Haghighi AB, Edgell RC, Cruz-Flores S, et al. Mortality of cerebral venous–sinus thrombosis in a large national sample. Stroke. 2012;43(1):262-264.
- 3. Preter M, Tzourio C, Ameri A, Bousser MG. Long-term prognosis in cerebral venous thrombosis: follow-up of 77 patients. Stroke. 1996;27(2):243-246.
- 4. Chiewvit P, Piyapittayanan S, Poungvarin N. Cerebral venous thrombosis: diagnosis dilemma. Neurology international. 2011;3(3):e13.
- 5. Tanislav C, Siekmann R, Sieweke N, et al. Cerebral vein thrombosis: clinical manifestation and diagnosis. BMC neurology. 2011;11(1):1-5.
- 6. Li Y, Zhang M, Xue M, Wei M, He J, Dong C. A case report of cerebral venous sinus thrombosis presenting with rapidly progressive dementia. Frontiers in Medicine. 2022;9:985361.
- 7. Ferro JM, Bousser MG, Canhão P, et al. European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis–endorsed by the European of Neurology. ESJ. 2017;2(3):195-221.
- 8. Garvey CJ, Hanlon R. Computed tomography in clinical practice. BMJ. 2002;324(7345):1077-1080.
- 9. Yiğit H, Turan A, Ergün E, Koşar P, Koşar U. Time-resolved MR angiography of the intracranial venous system: an alternative MR venography technique. ER. 2012;22:980-989.
- 10. Ghoneim A, Straiton J, Pollard C, Macdonald K, Jampana R. Imaging of cerebral venous thrombosis. Clinical radiology. 2020;75(4):254-264.
- 11. van Dam LF, van Walderveen MA, Kroft LJ, et al. Current imaging modalities for diagnosing cerebral vein thrombosis–A critical review. Thrombosis research. 2020;189:132-139.
- 12. Sadik JC, Jianu DC, Sadik R, Purcell Y, et al. Imaging of Cerebral Venous Thrombosis. Life. 2022;12(8):1215.
- 13. Petcharunpaisan S, Ramalho J, Castillo M. Arterial spin labeling in neuroimaging. WJR. 2010;2(10):384.
- 14. Chen J, Licht DJ, Smith SE, Agner SC, et al. Arterial spin labeling perfusion MRI in pediatric arterial ischemic stroke: initial experiences. JMRI. 2009;29(2):282-290.
- 15. Bokkers RP, Hernandez DA, Merino JG, Mirasol RV, et al. Whole-brain arterial spin labeling perfusion MRI in patients with acute stroke. Stroke. 2012;43(5):1290-1294.
- 16. Kang JH, Yun TJ, Yoo RE, Yoon BW et al. Bright sinus appearance on arterial spin labeling MR imaging aids to identify cerebral venous thrombosis. Medicine. 2017;96(41):e8244.
- 17. Sassi SB, Touati N, Baccouche H, Drissi C, Romdhane NB, Hentati F. Cerebral venous thrombosis: a Tunisian monocenter study on 160 patients. Clin. Appl. Thromb. Hemost. 2016;23:1005–1009.
- 18. Coutinho JM, Zuurbier SM, Aramideh M, Stam J. The incidence of cerebral venous thrombosis: a cross-sectional study. Stroke. 2012;43:3375–3377.
- 19. Devasagayam S, Wyatt B, Leyden J, Kleinig T. Cerebral venous sinus thrombosis incidence is higher than previously thought: a retrospective population-based study. Stroke. 2016;47:2180–2182.
- 20. Capecchi M, Abbattista M, Martinelli I. Cerebral venous sinus thrombosis. JTH. 2018;16(10):1918-1931.
- 21. Coutinho JM, Ferro JM, Canhão P, et al. Cerebral venous and sinus thrombosis in women. Stroke. 2019;40(7):2356-2361.
- 22. Copel J, El-Sayed Y, Heine RP, Wharton KR. Guidelines for diagnostic imaging during pregnancy and lactation. Obstetrıcs and Gynecology. 2016;127(2):E75-E80.
- 23. Idbaih A, Boukobza M, Crassard I, Porcher R, Bousser MG, Chabriat H. MRI of clot in cerebral venous thrombosis: high diagnostic value of susceptibility-weighted images. Stroke. 2006;37(4):991-995.
- 24. Lv B, Tian C, Cao X, Liu X, Wang J, Yu S. Role of diffusion-weighted imaging in the diagnosis of cerebral venous thrombosis. JIMR. 2020;48(6):0300060520933448.
- 25. Kwon H, Choi DS, Jang J. Susceptibility-Weighted MR Imaging for the Detection of Isolated Cortical Vein Thrombosis in a Patient with Spontaneous Intracranial Hypotension. IMRI. 2019;23(4):381-384.
- 26. Sabet S, Gürcan NI. Perfüzyon MR Görüntüleme. Türk Radyoloji Seminerleri. 2020;pp:252-258.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri (Diğer) |
| Bölüm | Orjinal Araştırma |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Eylül 2023 |
| Kabul Tarihi | 23 Eylül 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 13 Sayı: 5 |
