Utility of contrast-enhanced 3D turbo-flash MR angiography in evaluating the intracranial venous system

The objective of this study was to compare the effectiveness of contrast-enhanced 3D turbo-flash and 2D time-of-flight (TOF) magnetic resonance angiography (MRA) sequences in the visualization and evaluation of the intracranial venous system. A prospective study was carried out on 41 patients referred to our Magnetic Resonance Imaging (MRI) unit with clinical findings suggestive of dural sinus thrombosis. Contrast-enhanced 3D turbo-flash and 2D TOF MRA sequences were performed, and the dural sinuses and cerebral veins were classified into five grades according to the quality of visualization and presence of thrombosis. We found the dural sinuses and cerebral veins to be normal in all sequences in 31 patients. Thrombosis of dural sinuses was detected in ten patients, with four of these ten cases found only in the contrast-enhanced 3D turbo-flash sequence. In general, complete visualization of cerebral veins and dural sinuses was significantly better accomplished with contrast-enhanced 3D turbo-flash MRA than with 2D TOF in either coronal or sagittal/oblique planes. Although 2D TOF MRA may be superior in detecting chronic dural sinus thrombosis, contrast-enhanced 3D turbo-flash MRA sequences may offer advantages for the early diagnosis and management of acute and subacute dural sinus thrombosis.