Venous Infarct/ Sinus THROMBOSIS MRI Protocol

• SAG T1
• AXIAL T2
• AXIAL FLAIR
• AXIAL DWI
• AXIAL T1w

POST CONTRAST 

• AXIAL T1 POST
• COR 3D
• 2D COR MRV

Flow-sensitive imaging techniques can be used (ie, 2-dimensional time-of-flight [2D TOF] or phase-contrast MRV) to accurately assess the venous sinuses; 2D TOF MRV pulse sequence is sensitive to slow flow. 

Venous infarction is frequently hemorrhagic. Gradient-echo axial images are more sensitive to hemorrhagic products.

In acute venous thrombosis, loss of flow void on T1-weighted images occurs along with hypointensity on T2-weighted images, making the determination of sinus occlusion difficult. In the subacute phase, blood clot can result in loss of normal flow void on T1-weighted images and T1 hyperintensity; conversely, on T2-weighted images, blood clot can be of low signal intensity, thus mimicking flowing blood. In this instance, blood is in the intracellular methemoglobin stage.

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