EURORAD ESR

Case 643

Completely thrombosed aneurysm of the persistent, primitive prosencephalic vein of Markowski

Author(s)
R. N. Sener, O. Yalman, O. Kitis, S Tamsel, C. Calli
 
Patient
male, 4 month(s)
 
 
  • Published 11.12.2000
  • DOI 10.1594/EURORAD/CASE.643
  • Section Neuroradiology
  • Case Type Clinical Cases
  • Difficulty Resident
  • Views 3604
  • Language(s)
  • Figure 1
    Spontaneous thrombosis in a homogenous fashion
     

    Sagittal T1-weighted image shows a large mass compressing the aqueduct and the surrounding structures with resultant hydrocephalus. The walls of the malformation appears to be thick. Note absence of flow void, and...

     
    Area of Interest: unknown; Imaging Technique: Spontaneous thrombosis in a homogenous fashion;

    Coronal proton-density weighted image shows the lesion. Again, there is no flow void.

     
    Area of Interest: unknown; Imaging Technique: Spontaneous thrombosis in a homogenous fashion;

    Coronal T2-weighted image reveals relatively more hypointensity in the malformation, but no flow void.

     
    Area of Interest: unknown; Imaging Technique: Spontaneous thrombosis in a homogenous fashion;

    FLAIR (fluid attenuated inversion recovery) image reveals high signal, and no flow void within the malformation.

     
    Area of Interest: unknown; Imaging Technique: Spontaneous thrombosis in a homogenous fashion;
     
     
  • Figure 2
    MR angiography in complete thrombosis
     

    Source image from a 2D-TOF sequence reveals relatively high signal in the malformation.

     
    Area of Interest: unknown; Imaging Technique: MR angiography in complete thrombosis;

    Source image from a 3D-TOF sequence also reveals high signal.

     
    Area of Interest: unknown; Imaging Technique: MR angiography in complete thrombosis;

    MIP from 3D-TOF angiography is confusing, and shows the feeders from the posterior cerebral arteries as direct fistulas. There is an impression that free flow within the malformation is evident. However, this is a...

     
    Area of Interest: unknown; Imaging Technique: MR angiography in complete thrombosis;

    3D-PC angiography (flow velocity = 30 cm/sec) reveals no flow in the malformation, suggesting that it is thrombosed.

     
    Area of Interest: unknown; Imaging Technique: MR angiography in complete thrombosis;
     
     
Sagittal T1-weighted image shows a large mass compressing the aqueduct and the surrounding structures with resultant hydrocephalus. The walls of the malformation appears to be thick. Note absence of flow void, and instead, there is a relatively high signal within the malformation. This is a strong indicator of thrombosis of the malformation.
 
Coronal proton-density weighted image shows the lesion. Again, there is no flow void.
 
Coronal T2-weighted image reveals relatively more hypointensity in the malformation, but no flow void.
 
FLAIR (fluid attenuated inversion recovery) image reveals high signal, and no flow void within the malformation.
 
Source image from a 2D-TOF sequence reveals relatively high signal in the malformation.
 
Source image from a 3D-TOF sequence also reveals high signal.
 
MIP from 3D-TOF angiography is confusing, and shows the feeders from the posterior cerebral arteries as direct fistulas. There is an impression that free flow within the malformation is evident. However, this is a false impression, and reflects the known T1 sensitivity (for blood products, contrast medium, and fat) of the TOF sequence. Herein, completely and homogenously thrombosed blood products create a false impression of normally flowing blood.
 
3D-PC angiography (flow velocity = 30 cm/sec) reveals no flow in the malformation, suggesting that it is thrombosed.
 
 
 
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