Non-lower extremity deep vein thrombosis

Dural venous sinus thrombosis in a patient with sickle cell disease: case report and literature review

We report a case of dural venous sinus thrombosis (DVST) in a patient who developed seizures following exchange transfusion for treatment of acute chest syndrome associated with sickle cell disease. Evaluation with magnetic resonance imaging and magnetic resonance venography of the brain indicated left sigmoid sinus thrombosis. The history and laboratory evaluation did not reveal any other inherited or acquired hypercoagulable states. This is the fourth case of dural venous sinus thrombosis associated with sickle cell disease reported in literature. The patient had a favorable outcome with early treatment of unfractionated heparin.

Current DVT imaging

Accurate diagnosis of deep venous thrombosis (DVT) is very difficult, and imaging plays a crucial role in the diagnosis or exclusion of DVT. The initial test of choice for diagnosis of acute thigh as well as upper extremity DVT is ultrasound, because of its high accuracy, relatively low cost, portability, and lack of ionizing radiation. In patients who are undergoing CT pulmonary angiography for suspected pulmonary embolism, CT venography can be performed as part of the examination, for comprehensive evaluation of the venous system in the legs, abdomen, and pelvis. MR has a problem-solving role, and conventional venography is now limited to specific scenarios including evaluation of central DVT in the upper extremities, as a prelude to intervention for thrombolysis/thrombectomy, and prior to placement of an inferior vena cava filter. This article discusses the imaging findings of DVT, and the role of these imaging examinations in the evaluation of patients with suspected DVT.