| Echocontrast-enhanced transcranial color-coded sonography for the diagnosis of transverse sinus venous thrombosis. | |
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MedLine Citation:
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PMID: 9099181 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: Early diagnosis of cerebral transverse sinus venous thrombosis (TSVT) is difficult because of nonspecific and variable clinical presentations. Therefore, we evaluated the diagnostic value of transcranial color-coded duplex sonography (TCCS) after administration of an echocontrast-enhancing agent (cTCCS) in clinically suspected TSVT. METHODS: We examined 14 patients (6 men, 8 women; mean age, 48 years; range, 18 to 70 years) with signs and symptoms suggestive of cerebral TSVT. Color-coded signals from the contralateral transverse sinus were displayed transtemporally before and after injections of an echocontrast agent by TCCS. Sonographic findings were correlated with MRI and MR venography (MRV). RESULTS: Before echocontrast enhancement, TCCS displayed color Doppler signals in 7 of 28 transverse sinus. Echocontrast TCCS obtained sufficient color signals in 27 of 28 transverse sinus. Thus, diagnostic confidence was achieved in all but 1 patient. In 13 patients, cTCCS identified 3 cases with symmetrical blood flow in the transverse sinus, which was confirmed by MRV. Accordingly, asymmetry of venous blood flow was correctly assessed by cTCCS in the other 10 patients. In 6 of these 10 patients, cTCCS demonstrated residual color flow signals, which on MRI/MRV corresponded to partial TSVT (4 cases) and to hypoplasia (1 case) of the transverse sinus. One case of complete thrombotic occlusion of the transverse sinus was missed by cTCCS because of color Doppler signals originating from an adjacent dural fistula. Echocontrast TCCS diagnosis of occlusion of a transverse sinus was confirmed by MRI/MRV in all cases (aplasia of transverse sinus, n = 1; complete TSVT, n = 3). Systolic peak flow velocities were significantly decreased in hypoplastic or partially occluded transverse sinus (9.4 +/- 4.0 cm/s) and significantly increased contralaterally (28.4 +/- 6.5 cm/s) with respect to patients with symmetrical appearance of the transverse sinus (17.5 +/- 1.9 cm/s) (P < .05). CONCLUSIONS: TCCS examination of the cerebral venous system is difficult without contrast media application and almost useless for the study of TSVT. However, cTCCS is of practical value in the initial workup of patients with clinically suspected TSVT and may provide further insight for follow-up studies in view of monitoring the recanalization. |
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Authors:
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S Ries; W Steinke; K W Neff; M Hennerici |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: 28 ISSN: 0039-2499 ISO Abbreviation: Stroke Publication Date: 1997 Apr |
Date Detail:
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Created Date: 1997-05-01 Completed Date: 1997-05-01 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 696-700 Citation Subset: IM |
Affiliation:
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Department of Neurology, University of Heidelberg, Klinikum Mannheim, Germany. daffi@neuropc1.neuroma.uni-heidelberg.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Blood Flow Velocity Cerebrovascular Circulation Contrast Media* Female Humans Magnetic Resonance Imaging Male Middle Aged Polysaccharides / diagnostic use* Sinus Thrombosis, Intracranial / diagnosis, physiopathology, ultrasonography* Tomography, X-Ray Computed Ultrasonography, Doppler, Color* Ultrasonography, Doppler, Transcranial* |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 0/Polysaccharides; 127279-08-7/SHU 508 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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