To establish the value of time-resolved contrast-enhanced magnetic resonance angiography (TR-MRA) in identifying transverse sinus (TS) thrombosis in patients with a unilaterally absent TS signal on phase-contrast (PC) magnetic resonance venography (MRV).Forty-five patients who were suspected of TS thrombosis clinically with a unilaterally absent TS signal on PC MRV were evaluated using TR-MRA. The image quality was compared between PC MRV and TR-MRA via calculating signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNRs) of the normal TS. Images obtained by PC MRV and TR-MRA were assessed independently by two neuroradiologists regarding whether the absent signal was thrombosis or hypoplastic TS. Then a consultant neurologist made the final diagnosis based on all available clinical, laboratory, and radiological results (delivered by a consultant neuroradiologist via computed tomography [CT]/CT venography, magnetic resonance imaging [MRI]/MRV or digital subtraction angiography [DSA]), which was set as the reference standard. The accuracy of the radiological diagnosis from both techniques was assessed.For image quality, the SNRs and CNRs of TR-MRA were 452.14 and 440.92, respectively, significantly higher than that of PC MRV (both p0.001). The interobserver agreement of TR-MRA in identifying TS thrombosis from hypoplastic TS was excellent (κ = 0.951; 95% confidence interval [CI], 0.902-1), much higher than PC MRV (κ = 0.526; 95% CI, 0.389-0.663). Consensus of assessment based on TR-MRA was highly consistent with the reference standard (100% sensitivity, 96.67% specificity) and superior to PC MRV (60% sensitivity, 90% specificity).TR-MRA is better than PC MRV for visualising TS and distinguishing thrombosis from congenitally atretic TS.