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Combined Imaging Approach may Provide Better Identification of Difficult-to-diagnose Brain Clots

University of Cincinnati (UC) neuroradiologists believe a brain imaging approach that combines standard magnetic resonance imaging (MRI) scans with specialized// contrast-enhanced techniques could lead to more effective diagnoses in patients with difficult-to-detect blood clots in veins of the brain.

James Leach, MD, reports these findings in the April issue of the American Journal of Neuroradiology. This is the first study to correlate the clinical importance of data gleaned from standard MRI scans and detailed contrast-enhanced imaging techniques in patients with chronic thrombosis (blood clots) in veins of the brain.

"Detailed contrast-enhanced techniques produce more defined distinctions between abnormal and normal veins in the membrane around the brain," explains Leach, a neuroradiologist and associate professor at UC and principal investigator of the study. "Evaluating patients using a combination of imaging tools could give us a better understanding of the disease process."

Researchers say these specialized techniques—known as contrast-enhanced magnetic resonance venography—produce better defined pictures of difficult-to-detect abnormal flow areas within vessels of the brain. These areas may be important warning signs of blocked blood flow that require medical intervention. The enhanced imaging tools can also help identify areas where flow has been partially reestablished after a vessel blockage has occurred.

Leach and his team used these contrast-enhanced techniques, in combination with standard MRI scans, to evaluate a small subgroup of patients who have clinical and imaging features consistent with what is called partially recanalized chronic dural sinus thrombosis. This is a condition in the membrane surrounding the brain where blood flow has been partially reestablished in a previously blocked vessel.

Research has shown that cerebral veins partially or fully blocked by a blood clot—with or witho
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