Evaluation of transverse sinus stenosis with contrast-enhanced mri̇ in idiopathic intracranial hypertension

AIM: İn this study, we aimed to demonstrate transverse sinus stenosis and the other MRI findings of idiopathic intracranial hypertension could be identified with contrast enhanced cranial MRI in the patient who has diagnosis of İİH according to Revised Modified Dandy Criteria. MATERİAL AND METHOD: We include the patients who admitted to Dicle University Medical School Hospital between June 2013 and fabruary 2020 in this study. The patients who has no focal neurologic deficit,no intracranial mass, hydrocephalia or sinus vein thrombosis in neuroimaging, ≥250mm CSF pressure, younger than 60 and older than 18 year old. We have found our patients by searching the keywords in the digital archive that we use in our hospital, named PACS. We have selected 30 patients whom correspond the Revised Modified Dandy Criteria. We picked the control group by browsing the PACS system backwardly. We include patients who had normal C+ Cranial MRI, similar age and gender proposition with the patient group. The exclusion criterias we being younger than 18 and older than 60 year old, having any cause of secondary intracranial hypertension in C+ Cranial MRI, <250mm CSF pressure, , not having C+ Cranial MRI or lumbar punction procedure, treated wit therapeutic shunt procedure. We include 30 İİH patient and 50 control group in this study. We evaluate the most frequent MRI findings of İİH such as partially empty sella, dilated optic nerve sheath, posterior globe flattening, vertical tortuosity of optic nerve and dilated trigeminal sisterns with cranial MRI. We evaluate TSS by measuring proximal and distal diameter of the transvers sinuses in coronal and axial reformatted version of the contrast enhanced 3D T1 MRG. FİNDİNGS: There was no significant age and gender difference between two group. We identified partially empty sella in 24 patient (% 80), dilated optic nerve sheath 24 patient (% 80), Transverse sinus stenosis in 22 patient (%73), posterior globe flattening in 17 patient (%56), vertical tortuosity of optic nerve in 8 patient (%26), and dilated trigeminal sisterns in 3 patient (%10). Partially empty sella , dilated optic nerve sheath, Transverse sinus stenosis,posterior globe flattening, vertical tortuosity of optic nerve and dilated trigeminal sisterns we statistically significant in patient group in comparison with control group. RESULTS: İn this study we identified the most sensitive MRI findings of İİH as partially empty sella and dilated optic nerve sheath (%80). Also posterior globe flattening, vertical tortuosity of optic nerve and dilated trigeminal sisterns we statistically significant in patient group in comparison with control group. We identified TSS %73 of the patients by using the C+ Cranial MRI. Neuroradiologists can detect TSS without assistance of MRV or CTA. We conclude that TSS and the other MRI findings of İİH can be evaluated with C+ Cranial MRI in one session. KEY WORDS: Transverse sinus stenosis, idiopathic intracranial hypertension, Pseudotumor cerebri, C+ Cranial MRI