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Paradoxical parasellar high signals resembling shunt diseases on routine 3D time-of-flight MR angiography of the brain: mechanism for the signals and differential diagnosis from shunt diseases.

Abstract：

BACKGROUND AND PURPOSE:We occasionally encounter phenomena in which venous flow signals of the cavernous sinus (CS) and/or inferior petrosal sinus (IPS) are visualized paradoxically in patients without arteriovenous shunt in 3D time-of-flight magnetic resonance angiography (3D-TOF MRA) of the brain. The aims of this study are to examine the frequency and cause of this phenomenon ("pseudo-shunt" image) and to determine points of differentiation from definite arteriovenous shunt images ("real shunt"). METHODS:We retrospectively examined 85 maximum intensity projection images obtained by MRA in the absence of arteriovenous shunts to detect pseudo-shunt images, and evaluated source images of pseudo-shunt studies for venous structures. Four real-shunt MRA studies were compared with pseudo-shunt studies on three points: (1) extension of sinuses, (2) extension of cortical veins, and (3) signal intensity of sinuses as assessed by the scoring method (1 point when these findings exist, 0 when they do not). RESULTS:We detected five CS (3%) and six IPS (4%) signals in 9 (11%) of the 85 cases. In the source images of four pseudo-shunt images in the CS, we detected signals from the sphenoparietal sinus (SPS). The average score was significantly lower in the pseudo-shunt (0.22) than the real-shunt (2.75) images (P < .0001). CONCLUSION:In cerebral 3D-TOF MRA, pseudo-shunt images were seen in 11% (9/85) of the study population, with antegrade upward blood flow of the SPS considered as one of the causes. Real-shunt signals can be distinguished from pseudo-shunt signals by evaluation of source images.

journal_name

Magn Reson Imaging

journal_title

Magnetic resonance imaging

authors

Sakamoto M,Taoka T,Iwasaki S,Nakagawa H,Fukusumi A,Takayama K,Wada T,Kichikawa K

doi

10.1016/j.mri.2004.08.004

subject

Has Abstract

pub_date

2004-11-01 00:00:00

pages

1289-93

issue

eissn

0730-725X

issn

1873-5894

pii

S0730-725X(04)00246-2

journal_volume

pub_type

杂志文章

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Paradoxical parasellar high signals resembling shunt diseases on routine 3D time-of-flight MR angiography of the brain: mechanism for the signals and differential diagnosis from shunt diseases.