PT  - JOURNAL ARTICLE
AU  - Wang, G.
AU  - Yang, X.
AU  - Duan, J.
AU  - Zhang, N.
AU  - Maya, M.M.
AU  - Xie, Y.
AU  - Bi, X.
AU  - Ji, X.
AU  - Li, D.
AU  - Yang, Q.
AU  - Fan, Z.
TI  - Cerebral Venous Thrombosis: MR Black-Blood Thrombus Imaging with Enhanced Blood Signal Suppression
AID  - 10.3174/ajnr.A6212
DP  - 2019 Oct 01
TA  - American Journal of Neuroradiology
PG  - 1725--1730
VI  - 40
IP  - 10
4099  - http://www.ajnr.org/content/40/10/1725.short
4100  - http://www.ajnr.org/content/40/10/1725.full
SO  - Am. J. Neuroradiol.2019 Oct 01; 40
AB  - BACKGROUND AND PURPOSE: The residual blood flow artifact is a critical confounder for MR black-blood thrombus imaging of cerebral venous sinus thrombosis. This study aimed to conduct a validation of a new MR black-blood thrombus imaging technique with enhanced blood signal suppression.MATERIALS AND METHODS: Twenty-six participants (13 volunteers and 13 patients) underwent conventional imaging methods followed by 2 randomized black-blood thrombus imaging scans, with a preoptimized delay alternating with nutation for tailored excitation (DANTE) preparation switched on and off, respectively. The signal intensity of residual blood, thrombus, brain parenchyma, normal lumen, and noise on black-blood thrombus images were measured. The thrombus volume, SNR of residual blood, and contrast-to-noise ratio for residual blood versus normal lumen, thrombus versus residual blood, and brain parenchyma versus normal lumen were compared between the 2 black-blood thrombus imaging techniques. Segmental diagnosis of venous sinus thrombosis was evaluated for each black-blood thrombus imaging technique using a combination of conventional imaging techniques as a reference.RESULTS: In the volunteer group, the SNR of residual blood (11.3 ± 2.9 versus 54.0 ± 23.4, P < .001) and residual blood-to-normal lumen contrast-to-noise ratio (7.5 ± 3.4 versus 49.2 ± 23.3, P < .001) were significantly reduced using the DANTE preparation. In the patient group, the SNR of residual blood (16.4 ± 8.0 versus 75.0 ± 35.1, P = .002) and residual blood-to-normal lumen contrast-to-noise ratio (12.4 ± 7.8 versus 68.8 ± 35.4, P = .002) were also significantly lower on DANTE-prepared black-blood thrombus imaging. The new black-blood thrombus imaging technique provided higher thrombus-to-residual blood contrast-to-noise ratio, significantly lower thrombus volume, and substantially improved diagnostic specificity and agreement with conventional imaging methods.CONCLUSIONS: DANTE-prepared black-blood thrombus imaging is a reliable MR imaging technique for diagnosing cerebral venous sinus thrombosis.BTIblack-blood thrombus imagingCEcontrast-enhancedCNRcontrast-to-noise ratioCVTcerebral venous sinus thrombosisDANTEdelay alternating with nutation for tailored excitationTSEturbo spin-echoSPACEsampling perfection with application-optimized contrasts by using different flip angle evolution