Magnetic resonance imaging in chronic cavernous sinus thrombosis

Magnetic resonance (MR) imaging was performed in a female patient with a ch ronic septic form of cavernous sinus thrombosis. She developed diplopia, he adache, and high fever one month after paranasal sinus surgery. Magnetic re sonance imaging (MRI) revealed an isointense lesion in the right cavernous sinus with a decreased caliber of intracavernous internal carotid artery on T1-weighted coronary and axial plane. After gadolinium injection, the lesi on was well enhanced on T1-weighted image. On T2-weighted image, the lesion appeared as a heterogenous hypointense mass in the cavernous sinus. Her sy mptoms and signs subsided after intensive antibiotic treatment for more tha n one month. Follow-up MRI showed a decreased size of the thrombus in the r ight cavernous sinus. MRI provides a precise understanding of normal anatom y and demonstrates details of the complex structures in the cavernous sinus . It is also a very good tool to study the flow character of blood and cere bral spinal fluid. In cavernous sinus thrombosis, MRI provides important di agnostic information concerning the flow status in the cavernous sinus and the involutional process of both thrombus formation and its disintegration.