Empty delta sign (dural venous sinus thrombosis)
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View Frank Gaillard's current disclosures- Empty delta sign
The empty delta sign is a CT sign of dural venous sinus thrombosis of the superior sagittal sinus, where contrast outlines a triangular filling defect, which represents thrombus. It is only described in contrast-enhanced CT, and not in unenhanced scans.
An equivalent appearance can be noted in the transverse sinus on sagittal or coronal planes.
On this page:
Pathology
The exact mechanism for this appearance is uncertain, with possibilities including:
recanalization around an organizing clot
enlargement of the peridural small veins: a vascular mesh (dural cavernous spaces), and meningeal venous tributaries
thickening of the dura with increased enhancement
History and etymology
Delta or 'Δ' is the Greek letter with the sound of the English letter 'D' and has a triangular shape. Hence river delta or delta-shaped wing.
Practical points
Caution must be taken to achieve a well-timed acquisition in CT cerebral venography, particularly in cases of intracranial hypertension which can cause delayed filling of the venous sinus. A premature acquisition may create a false impression of thrombosis, which is simply due to contrast not yet reaching the venous sinuses. The cerebral veins should also be opacified on a CT cerebral venogram; if they are not, one should suspect premature acquisition.
References
- 1. Lee E. The Empty Delta Sign. Radiology. 2002;224(3):788-9. doi:10.1148/radiol.2243990978 - Pubmed
- 2. Virapongse C, Cazenave C, Quisling R, Sarwar M, Hunter S. The Empty Delta Sign: Frequency and Significance in 76 Cases of Dural Sinus Thrombosis. Radiology. 1987;162(3):779-85. doi:10.1148/radiology.162.3.3809494 - Pubmed
Incoming Links
- Bithalamic venous infarct
- Cerebral venous infarction
- Disseminated medulloblastoma associated with dural venous sinus thrombosis
- Dural venous sinus thrombosis
- Bi-thalamic infarction from internal cerebral vein thrombosis
- Cerebral venous thrombosis
- Cerebral venous haemorrhagic infarction
- Cerebral venous infarcts secondary to superior sagittal sinus thrombosis
- Cerebral venous thrombosis (CVT)
- Superior sagittal sinus thrombosis with persistent falcine sinus
- Acute superior sagittal sinus thrombosis
- Haemorrhagic venous infarction
- Dural venous sinus thrombosis with intracerebral haemorrhage
- Dural venous sinus thrombosis extending into the right internal jugular vein
- Cerebral venous thrombosis - haemorrhagic venous infarction
- Superior sagittal sinus thrombosis
- Dural venous sinus thrombosis
- Dural sinus thrombosis - empty delta sign
- Dural venous sinus thrombosis - empty delta sign
- Venous sinus thrombosis
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