Quantitative Study On Stage And Volume Of Cerebral Venous Thrombosis By Magnetic Resonance Vessel Wall Imaging

Objective:To investigate the application value of magnetic resonance vessel wall imaging in differentiating the course of Cerebral venous thrombosis and venous sinus thrombosis and measuring thrombosis volume in patients with Cerebral venous thrombosis(CVT).Methods:From May 2017 to December 2020,retrospectively collected 52 patients with CVT diagnosed by Computed tomography(CT)scan,Magnetic resonance imaging(MRI),Magnetic resonance venography(MRV)and other routine imaging examinations and clinical symptoms in the Department of Neurology and Neurosurgery of the First Hospital of Jilin University.All patients also underwent 3.0T MRI 3D T1-weighted sequence of volumetric isotropic turbo spin echo acquisition(3D T1VISTA)sequence examination.The general clinical data and risk factors of the patients were analyzed,and the sensitivity and specificity of 3D T1 Vista sequence examination at vascular segmental level were calculated with MRV examination results as reference.Patients were divided into acute group(≤14 days)and chronic group(>14 days)according to the time from the onset of symptoms to 3D T1 VISTA sequence examination.Signal to noise ratio(SNR)and Contrast to noise ratio(CNR)of thrombus to lumen and thrombus to gray matter between acute and chronic CVT groups were calculated and compared.In addition,the total thrombus volume of intracranial vein and venous sinus of each patient was calculated,and the correlation between thrombus volume and general clinical data,risk factors,occurrence of cerebral hemorrhage lesions and treatment time was analyzed.Results:1.Among the 52 enrolled patients,the mean age was 37±15 years,and30 of them were male(58%).The clinical manifestations showed no obvious specificity.The most common clinical manifestation was headache(87%),and anemia(25%)was the most frequent risk factor.2.Using MRV results as reference criteria,the sensitivity and specificity of 3D T1 VISTA for CVT diagnosis were 96.0%(190/198)and 99.2%(526/530).3.Thrombosis was diagnosed at 198 vascular levels by MRV,and at 194 vascular levels by 3D T1 VISTA.The difference between the two results was mainly in the transverse sinus,sigmoid sinus and superior sagittal sinus,and the proportion of transverse sinus thrombosis was the largest in both results,followed by sigmoid sinus.4.The SNR of acute and chronic thrombosis detected by 3D T1 VISTA were 235±43 and 124±47,respectively.CNR(thrombus and lumen)were227±42 and 117±48,respectively.CNR(thrombus and gray matter)were103±46 and 16±50,respectively,and there were statistically significant differences between the two groups(t values respectively were 8.584,8.509 and 6.275,P<0.01).5.The correlation analysis between thrombus volume and general clinical data and risk factors showed that there was a positive correlation between focal neurological dysfunction and anemia and thrombus volume,and the t values respectively were-2.087 and-2.292,which was statistically significant(P <0.05).6.The thrombus volume of the hemorrhagic disease group and the nonhemorrhagic disease group was 3.45±2.36cm~3 and 6.42±4.14cm~3,respectively,and the difference between the two groups was statistically significant(t value was-2.853,P=0.006).The mean thrombus volume of the hemorrhagic disease group was smaller than that of the nonhemorrhagic disease group.7.Thrombosis was diagnosed in 72 intracranial veins or venous sinuses in the hemorrhagic disease group,and at 122 vascular segmental levels in the non-hemorrhagic disease group.Thrombosis in veins of Labbé was associated with the occurrence of cerebral hemorrhage lesions(P<0.05).There was no statistically significant difference in other thrombus sites between the two groups(P>0.05).8.There was no linear correlation between CVT thrombus volume and treatment time(correlation coefficient r was-0.195,P>0.05).Conclusions:1.Different from conventional imaging,magnetic resonance vessel wall imaging can directly show thrombosis,and has high sensitivity and specificity in the diagnosis of intracranial venous thrombosis.2.Magnetic resonance vessel wall imaging can effectively distinguish acute and chronic thrombosis and has obvious advantages in the early diagnosis of CVT.3.Intracranial venous thrombosis volume can be measured by magnetic resonance vessel wall imaging,and thrombosis volume is associated with the occurrence of focal neurological dysfunction,anemia and intracerebral hemorrhage lesions.