Volume 31, Issue 3 (June 2020)
Studies in Medical Sciences 2020, 31(3): 209-218 |
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Javadrashid R, Daghighi M H, Bakhshi R. VALUE OF NON-CONTRAST CT AND VENOUS DENSITY MEASUREMENT IN THE DIAGNOSIS OF CEREBRAL VENOUS THROMBOSIS: A CASE-CONTROL STUDY. Studies in Medical Sciences 2020; 31 (3) :209-218
URL: http://umj.umsu.ac.ir/article-1-4967-en.html
URL: http://umj.umsu.ac.ir/article-1-4967-en.html
Assistant of Radiology, Department of Radiology, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran. (Corresponding Author) , robabbakhshi@gmail.com
Abstract: (24029 Views)
Background & Aims: Cerebral venous thrombosis (CVT) is relatively uncommon but important. Because of non-specific signs and symptoms, non-contrast computed tomography (NCT) is performed for most patients. The first aim of this study was to investigate the sensitivity and specificity of NCT in the diagnosis of CVT. Another aim was to assess the value of sinus venous attenuation measurement on NCT in the diagnosis of CVT.
Materials & Methods: NCT of 187 patients were reviewed. Sensitivity and specificity of NCT were evaluated in the diagnosis of CVT. Hounsfield unit (HU) of sinus venous with thrombus was compared to normal veins of control group, with and without standardization to the average HU of the internal carotids.
Results: CVT was confirmed in 32 patients by MRV (Magnetic Resonance Venography(. NCT has high sensitivity and specificity in the diagnosis of CVT. A significant difference in average venous sinus attenuation was found between thrombus in patients with CVT (66.12±7.4 HU) and normal veins in the control group (48.59±5.91 HU; p<0.05). A similar difference is identified between standardized HU value in venous sinuses with thrombus (1.59±0.24) and venous sinuses without thrombus (1.06±0.14; p<0.05). A HU of >62 and a standardized HU of >1.4 on NCT are associated with high probability of CVT.
Conclusion: High sensitivity of NCT and using sinus venous attenuation can be helpful for the early diagnosis and treatment of CVT in the emergency settings. Sinus venous attenuation value of >62 and standardized HU of >1.4 on NCT can be used as reliable methods to detect CVT.
Materials & Methods: NCT of 187 patients were reviewed. Sensitivity and specificity of NCT were evaluated in the diagnosis of CVT. Hounsfield unit (HU) of sinus venous with thrombus was compared to normal veins of control group, with and without standardization to the average HU of the internal carotids.
Results: CVT was confirmed in 32 patients by MRV (Magnetic Resonance Venography(. NCT has high sensitivity and specificity in the diagnosis of CVT. A significant difference in average venous sinus attenuation was found between thrombus in patients with CVT (66.12±7.4 HU) and normal veins in the control group (48.59±5.91 HU; p<0.05). A similar difference is identified between standardized HU value in venous sinuses with thrombus (1.59±0.24) and venous sinuses without thrombus (1.06±0.14; p<0.05). A HU of >62 and a standardized HU of >1.4 on NCT are associated with high probability of CVT.
Conclusion: High sensitivity of NCT and using sinus venous attenuation can be helpful for the early diagnosis and treatment of CVT in the emergency settings. Sinus venous attenuation value of >62 and standardized HU of >1.4 on NCT can be used as reliable methods to detect CVT.
Keywords: cerebral venous thrombosis, Hounsfield unit of venous sinus, non-contrast computed tomography, sensitivity, specificity
References
1. Stam J .Thrombosis of the cerebral vein and sinuses. N Engl J med 2005 ; 352: 1791-1798. [DOI:10.1056/NEJMra042354] [PMID]
2. Masuhr F, Mehraein S, Einhaupl K. Cerebral venous and sinus thrombosis. J Neurol 2004; 251: 11-23. [DOI:10.1007/s00415-004-0321-7] [PMID]
3. Linn J, Pfefferkorn T, Ivanicova K. Noncontrast CT in deep cerebral venous thrombosis and sinus thrombosis: comparison of its diagnostic value for both entities. AJNR Am J Neuroradio 2009; 30:728-732. [DOI:10.3174/ajnr.A1451] [PMID] [PMCID]
4. Saposnik G, Barinagarrementeria F, Brown RD J. Diagnosis and management of cerebral venous thrombosis: a statement for healthcare professional from the American Heart Association/American Stroke Association. Stroke 2011; 42:1158-1192. [DOI:10.1161/STR.0b013e31820a8364] [PMID]
5. Rizzo L, Crasto SG, Ruda R, Gallo G, Tola E, Garabello D, et al. cerebral venous thrombosis: role of CT, MRI and MRA in the emergency setting. Radiologia media 2010; 115(2): 313-325. [DOI:10.1007/s11547-010-0493-4] [PMID]
6. Wasay M, Azeemuddin M. Neuroimaging of cerebral venous thrombosis. J of Neuroimaging 2005; 15(2):118-128. [DOI:10.1111/j.1552-6569.2005.tb00296.x]
7. Qu H. and M. Yang, Early imaging characteristics of 62 cases of cerebral venous sinus thrombosis. Exp and Ther med, 2013; 5(1):233-236. [DOI:10.3892/etm.2012.796] [PMID] [PMCID]
8. Leech JL, Fortuna RB, Jones BV, Gaskill-shipley MF. Imaging of cerebral venous thrombosis: currant techniques, spectrum of findings and diagnostic pitfalls. Radiographic 2006; 26(1): 19-41. [DOI:10.1148/rg.26si055174] [PMID]
9. Renowden S. Cerebral venous thrombosis. Eur Radio 2004; 14: 215-226. [DOI:10.1007/s00330-003-2021-6] [PMID]
10. Teasdale E. Cerebral venous thrombosis: making the most of imaging. J R soc med 2000: 93: 234-237. [DOI:10.1177/014107680009300505] [PMID] [PMCID]
11. Bousser MG, Ferro JM. Cerebral venous thrombosis: an update. Lacet NeuroI. 2007; 6: 162-170. [DOI:10.1016/S1474-4422(07)70029-7] [PMID]
12. Garetier M, Rouseet J, Pearson E, Tissot V, Gentric JC, Nowak E, et al. Value of spontaneous hyperdensity of cerebral venous thrombosis on helical CT. Acta Radiol 2014; 55(10): 1245-1252. [DOI:10.1177/0284185113513977] [PMID]
13. Rottger E, Trittmacher S, Gerriets T, Blaes F, Kaps M, Stolz E . Reversible MR imaging abnormalities following cerebral venous thrombosis. AJNR 2005; 26(3): 607-613. [Google Scholar]
14. Buyck PJ, De Keyzer F, Vanneste D, Wilms G, Thijs V, Demaerel P. CT density measurement and H:H ratio are useful in diagnosing acute cerebral venous sinus thrombosis. AJNR 2013; 34(8): 1568-1572. [DOI:10.3174/ajnr.A3469] [PMID] [PMCID]
15. Alsafi A, Lakhani A, Carlton Jones L, Lobotesis K. Cerebral venous sinus thrombosis, a nonenhanced CT diagnosis? Radiol Res Pract. 2015;2015:1-5. Doi:10.1155/2015/581437. [DOI:10.1155/2015/581437] [PMID] [PMCID]
16. Avsenic J, Oblak JP, Popovic KS. Non-contrast computed tomography in the diagnosis of cerebral venous sinus thrombosis. Radiol oncol. 2016 sep 1;50(3):263-8. [DOI:10.1515/raon-2016-0026] [PMID] [PMCID]
17. Zaheer S, Lancu D, Seppala N, Patre S, Glikstein R, Thornhill R, et al. Quantitative non-contrast measurements improve diagnosing dural venous sinus thrombosis. Neuroradiology. 2016;58:657-663. [DOI:10.1007/s00234-016-1681-2] [PMID]
18. Roland T, Jacobs J, Rappaport A, Vanheste R, Wilms G, Demaerel P. Unenhanced brain CT is useful to decide on further imaging in suspected venous sinus thrombosis. Clin. Radiol. 2010;65:34-39. [DOI:10.1016/j.crad.2009.09.008] [PMID]
19. Digge P, Prakashini K, Bharat KV. Plain CT vs MR venography in acute cerebral venous sinus thrombosis: Triumphant dark horse. Indian J Of Radiol Imaging. 2018 Jul;28(3):280-284. [DOI:10.4103/ijri.IJRI_328_17] [PMID] [PMCID]
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