Arterial Spin Labelling Magnetic Resonance Perfusion Imaging for the Diagnosis of Acute Cerebral Venous Thrombosis

Yıl 2023, , 896 - 900, 30.09.2023

Ümit Görgülü , Hatice Gül Hatipoğlu Çetin

https://doi.org/10.16899/jcm.1349221

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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

Akut Serebral Venöz Tromboz Tanısında Arteriyel Spin Etiketleme Manyetik Rezonans Perfüzyon Görüntüleme

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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

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