Would you recommend a CT venogram or MR venogram in patients with concern for venous sinus thrombosis?

Either modality is suitable for assessing CVST. However, I typically prefer CTV. It's easier to obtain and has a quick scan time, which reduces the chances of motion artifacts. MRV provides better resolution, but it requires a screening form and has a longer scan time, which may lead to motion artifact if the patient cannot lie still for an extended period or has claustrophobia. The key with MRV is to order it with contrast. Obtaining a non-contrasted (time of flight) study will often yield inconclusive findings, which may necessitate CTV for clarification afterward. I apply the same rationale for CTA versus MRA.