Abstract
Background
Dural venous sinus ectasia with thrombosis (DVSET) in the fetus is a rare condition that can be diagnosed prenatally with the use of fetal MR imaging, yet with limited indication of long-term clinical significance.
Objective
To describe and evaluate the diagnostic value of fetal MR imaging in the prenatal diagnosis of dural venous sinus ectasia with thrombosis and its clinical significance.
Materials and methods
We report a series of nine fetuses with dural venous sinus ectasia with thrombosis. The mothers, located in four feto-maternal centres, were referred for fetal MR imaging due to space occupying lesions identified on second-trimester antenatal ultrasound.
Results
In all but one case the dural venous sinus ectasia with thrombosis was in the vicinity of the venous confluence (VC) with various extension in the posterior dural sinuses. Antenatal follow-up imaging was performed in seven cases and showed progression in one, stable appearances in one and regression in five cases. Three pregnancies were terminated. In the remaining six cases there was no reported neurological deficit at up to 44 months of clinical follow-up.
Conclusion
This is among the largest series of postnatal clinical follow-up in cases of prenatal diagnosis of dural venous sinus ectasia with thrombosis in the literature. Clinical follow-up suggests a good prognosis when antenatal follow-up shows partial or complete thrombus resolution.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Merzoug V, Flunker S, Drissi C et al (2008) Dural sinus malformation (DSM) in foetuses. Diagnostic value of prenatal MRI and follow up. Eur Radiol 18:692–699
Barbosa M, Mahadevan J, Weon YC et al (2003) Dural sinus malformations (DSM) with giant lakes, in neonates and infants. Review of 30 consecutive cases. Intervent Neuroradiol 9:407–424
Laurichesse Delmas H, Winer N, Gallot D et al (2008) Prenatal diagnosis of thrombosis of the dural sinuses: report of six cases, review of the literature and suggested management. Ultrasound Obstet Gynecol 32:188–198
McInnes M, Fong K, Grin A et al (2009) Malformations of the fetal dural sinuses. Can J Neurol Sci 36:72–77
Visentin A, Falco P, Pilu G et al (2001) Prenatal diagnosis of thrombosis of the dural sinuses with real-time color Doppler ultrasound. Ultrasound Obstet Gynecol 17:322–325
Komiyama M, Ishiguro T, Kitano S et al (2004) Serial antenatal sonographic observation of cerebral dural sinus malformation. AJNR Am J Neuroradiol 25:1446–1448
Legendre G, Picone O, Levaillant JM et al (2009) Prenatal diagnosis of a spontaneous dural sinus thrombosis. Prenat Diagn 29:808–813
Grigoriadis S, Cohen JE, Gomori JM (2008) Prenatal thrombosis of torcular Herophili with spontaneous resolution and normal outcome. J Neuroimaging 18:177–179
Schwartz N, Monteagudo A, Bornstein E et al (2008) Thrombosis of an ectatic torcular Herophili: anatomic localization using fetal neurosonography. J Ultrasound Med 27:989–992
Spampinato MV, Hardin V, Davis M et al (2008) Thrombosed fetal dural sinus malformation diagnosed with magnetic resonance imaging. Obstet Gynecol 111:569–572
Jung E, Won HS, Kim SK et al (2006) Spontaneous resolution of prenatally diagnosed dural sinus thrombosis: a case report. Ultrasound Obstet Gynecol 27:562–565
Rossi A, De Biasio P, Scarso E et al (2006) Prenatal MR imaging of dural sinus malformation: a case report. Prenat Diagn 26:11–16
Breysem L, Witters I, Spitz B et al (2006) Fetal magnetic resonance imaging of an intracranial venous thrombosis. Fetal Diagn Ther 21:13–17
Clode N, Cardoso C, Tavares J et al (2004) Prenatal diagnosis of thrombosis of dural sinuses. Ultrasound Obstet Gynecol 24:330
Emamian SA, Bulas DI, Vezina GL et al (2002) Fetal MRI evaluation of an intracranial mass: in utero evolution of hemorrhage. Pediatr Radiol 32:593–597
Gicquel JM, Potier A, Sitrik S et al (2000) Normal outcome after prenatal diagnosis of thrombosis of the torcular Herophili. Prenat Diagn 20:824–827
Zerah B, Zerah M, Swift D et al (2010) Giant dural venous sinus ectasia in neonates. J Neurosurg Pediatr 5:523–528
Byrd SE, Abramowicz JS, Kent P et al (2012) Fetal MR imaging of posterior intracranial dural sinus thrombosis: a report of three cases with variable outcomes. Pediatr Radiol 42:536–543
Padget DH (1955) The cranial venous system in man in reference to development, adult configuration and relation to the arteries. J Neurosurg 12:307–355
Raybaud CA, Strother CM, Hald JK (1989) Aneurysms of the vein of Galen: embryonic considerations and anatomical features relating to the pathogenesis of the malformation. Neuroradiology 31:109–128
Okudera T, Huang YP, Ohta T et al (1994) Development of posterior fossa dural sinuses, emissary veins, and jugular bulb: morphological and radiologic study. AJNR Am J Neuroradiol 15:1871–1883
Widjaja E, Griffiths PD (2004) Intracranial MR venography in children: normal anatomy and variations. AJNR Am J Neuroradiol 25:1557–1562
Conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Fanou, E.M., Reeves, M.J., Howe, D.T. et al. In utero magnetic resonance imaging for diagnosis of dural venous sinus ectasia with thrombosis in the fetus. Pediatr Radiol 43, 1591–1598 (2013). https://doi.org/10.1007/s00247-013-2745-7
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00247-013-2745-7