Phase-contrast magnetic resonance angiography for assessment of intracranial venous sinus lesions.

OBJECTIVE: To review the presentations of intracranial venous sinus lesions in phase-contrast (PC) magnetic resonance angiography (MRA) and discuss the diagnostic value of this imaging modality for these lesions. METHODS: This study involved 52 patients with intracranial venous sinus lesions, including 21 with dural venous sinus malformation, 7 dural arteriovenous fistula (6 caroticocaveneous fistula, CCF), 5 venous sinus thrombus and 19 meningioma invading the venous sinuses. All patients underwent PC and time-of-flight (TOF) MRA with a 1.5 Tesla MR scanner, with 28 of them undergoing subsequent digital subtraction angiography (DSA). RESULTS: PC MRA showed extensive hyperintense signals that identified the lesions, feeding arteries, deferent veins and venous sinuses in 21 cases of dural arteriovenous fistula, but the lesion signals appeared homogeneous. In these cases, PC and TOF MRA had equally good performance in displaying the feeding arteries with success in 20 of the 21 cases (95.2%), whereas the former resulted in a greater rate of deferent vein display [90.5% (19/21)] than the latter [76.2% (16/21), P<0.05]. The 6 CCF cases showed ipsilateral cavernous sinus expansion and upper ophthalmic vein dilations. In the 5 cases of venous sinus thrombis, 4 had transverse sinus thrombus and 1 superior sagittal sinus thrombus. All the cases presented signal disappearance in the sinuses in PC MRA and hyperintense signals in MRI, and some cases had also cerebral superficial hemorrhage and edema. The 19 cases of meningioma invading the venous sinus displayed sinus shift, stenosis and occlusion in PC MRA. CONCLUSION: PC MRA has great advantages in displaying the anatomical structure and lesions of the venous sinuses.