<abstract xmlns="http://www.w3.org/1999/xhtml"><sec><h3>Background</h3><p>The aim of the study was to investigate the sensitivity and specificity of non-contrast computed tomography (NCCT) in the diagnosis of cerebral venous sinus thrombosis (CVST).</p><p>Methods. Screening our neurological department database, we identified 53 patients who were admitted to neurological emergency department with clinical signs of CVST. Two independent observers assessed the NCCT scans for the presence of CVST. CT venography and/or MR venography were used as a reference standard. Interobserver agreement between the two readers was assessed using Kappa statistic. Attenuation inside the cerebral venous sinuses was measured and compared between the patient and the control group.</p></sec><sec><h3>Results</h3><p>CVST was confirmed in 13 patients. Sensitivity and specificity of NCCT for overall presence of CVST were 100% and 83%, respectively, with Kappa value of 0.72 (a good agreement between observers). The attenuation values between CVST patients and control group were significantly different (73.4 ± 14.12 HU <italic>vs</italic>. 58.1 ± 7.58 HU; p = 0.000). The ROC analysis showed an area under the curve (AUC) of 0.916 (95% CI, 0.827 – 1.00) and an optimal cutoff value of 64 HU, leading to a sensitivity of 85% and specificity of 87%.</p></sec><sec><h3>Conclusions</h3><p>NCCT as a first-line investigation has a high value for diagnosis of CVST in the emergency setting. The additional measurement of the sinus attenuation may improve the diagnostic value of the examination.</p></sec></abstract>

BackgroundThe aim of the study was to investigate the sensitivity and specificity of non-contrast computed tomography (NCCT) in the diagnosis of cerebral venous sinus thrombosis (CVST).Methods. Screening our neurological department database, we identified 53 patients who were admitted to neurological emergency department with clinical signs of CVST. Two independent observers assessed the NCCT scans for the presence of CVST. CT venography and/or MR venography were used as a reference standard. Interobserver agreement between the two readers was assessed using Kappa statistic. Attenuation inside the cerebral venous sinuses was measured and compared between the patient and the control group.ResultsCVST was confirmed in 13 patients. Sensitivity and specificity of NCCT for overall presence of CVST were 100% and 83%, respectively, with Kappa value of 0.72 (a good agreement between observers). The attenuation values between CVST patients and control group were significantly different (73.4 ± 14.12 HU vs. 58.1 ± 7.58 HU; p = 0.000). The ROC analysis showed an area under the curve (AUC) of 0.916 (95% CI, 0.827 – 1.00) and an optimal cutoff value of 64 HU, leading to a sensitivity of 85% and specificity of 87%.ConclusionsNCCT as a first-line investigation has a high value for diagnosis of CVST in the emergency setting. The additional measurement of the sinus attenuation may improve the diagnostic value of the examination.

Non-contrast computed tomography in the diagnosis of cerebral venous sinus thrombosis

Clinical Institute of Radiology, University Medical Centre, Ljubljana, Slovenia

Department of Neurology, University Medical Centre, Ljubljana, Slovenia

Radiology and Oncology

BackgroundThe aim of the study was to investigate the sensitivity and specificity of non-contrast computed tomography (NCCT) in the diagnosis of cerebral...

Patient No	Location of thrombus	Parenchymal changes
1	RTS, RSS	None
2	LTS	Hemorrhage, edema
3	SSS, RTS, RSS	None
4	RTS	None
5	SSS, RTS, RSS	None
6	SSS, LTS, LSS, right ICV, left ICV, VG	None
7	RTS, RSS	None
8	RTS, RSS	None
9	LTS, LSS	None
10	SSS, RTS, RSS, cortical veins	None
11	SSS, LTS, LSS	Hemorrhage, edema
12	RTS	Hemorrhage, edema
13	SSS, cortical veins	Hemorrhage, edema

Non-contrast computed tomography in the diagnosis of cerebral venous sinus thrombosis

Article Category: Research Article

Data publikacji: 19 lip 2016

Zakres stron: 263 - 268

Otrzymano: 09 lut 2015

Przyjęty: 06 mar 2016

DOI: https://doi.org/10.1515/raon-2016-0026

© Radiol Oncol 2016

This content is free.

Figure 1

Figure 2

Figure 3

Location of thrombus and parenchymal changes in 13 patients with cerebral venous sinus thrombosis (CVST)