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Evaluation of Diagnostic Values in NCCT and MRI of the Patients With Cerebral Venous or Sinus Thrombosis in Loghman Hakim Hospital in Tehran 2014-2018

Hossein Hatami, Niyousha Danesh, Maziar Shojaei, Amir Rabie Hamedani
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Abstract

Background: Cerebral venous and sinus thrombosis (CVT) is the rare type of stroke, which can be fatal or causes significant morbidity. CVT could cause by multiple etiologies and risk factors and could present with many signs and symptoms such as a headache, seizure or altered mental status. The gold standard for diagnosing CVT is magnetic resonance venography (MRV) or computed tomographic venography (CTV), as these modalities are not available in many health centers and the early diagnosis of this disease improves significantly the outcome of treatment, we evaluated the diagnostic values of CT and magnetic resonance imaging (MRI) in CVT patients.

Methods: We compiled and investigated the radiological and clinical records of 92 patients with the final diagnosis of CVT; we observed the sign of thrombosis in 74 patients who had either the non-contrast CT or MRI plus MRV. We statistically analyzed the sensitivity, specificity, positive predictive value, negative predictive value, accuracy, the positive and negative likelihood ratio of these modalities.

Results: Our results demonstrated that the sensitivity of CT scan is 60.5%, and its specificity is 66.7%. The positive predictive value of CT is 85%, and its negative predictive value is 34%. Our study demonstrated that the accuracy of CT in diagnosing CVT patients is 62%.

Besides our results showed that the sensitivity of MRI in diagnosing CVT is 87%, and the specificity of MRI is 76.9%. Hence the positive predictive value of MRI is 94%, and the negative predictive value is 58%, and the accuracy of this modality is 85%

Conclusion: In the absence of gold standard modalities, MRI and CT scan have relatively good diagnostic values, besides MRI is more beneficial between the two, moreover we found that CVT is more prevalent among women and in warm seasons.


Keywords

Cerebral venous and sinus thrombosis (CVT), CT, MRI, MRV, diagnosis

References

Ferro JM, Canhao P. Cerebral venous sinus thrombosis: update on diagnosis and management. Curr Cardiol Rep. 2014;16(9):523.

deVeber G, Andrew M, Adams C, Bjornson B, Booth F, Buckley DJ, et al. Cerebral sinovenous thrombosis in children. N Engl J Med. 2001;345(6):417-23.

Bousser MG, Ferro JM. Cerebral venous thrombosis: an update. Lancet Neurol. 2007;6(2):162-70.

Stam J. Thrombosis of the cerebral veins and sinuses. N Engl J Med. 2005;352(17):1791-8.

Coutinho JM, Ferro JM, Canhao P, Barinagarrementeria F, Cantu C, Bousser MG, et al. Cerebral venous and sinus thrombosis in women. Stroke. 2009;40(7):2356-61.

Carhuapoma JR, Mitsias P, Levine SR. Cerebral venous thrombosis and anticardiolipin antibodies. Stroke. 1997;28(12):2363-9.

Lijfering WM, Brouwer JL, Veeger NJ, Bank I, Coppens M, Middeldorp S, et al. Selective testing for thrombophilia in patients with first venous thrombosis: results from a retrospective family cohort study on absolute thrombotic risk for currently known thrombophilic defects in 2479 relatives. Blood. 2009;113(21):5314-22.

Martinelli I, Bucciarelli P, Passamonti SM, Battaglioli T, Previtali E, Mannucci PM. Long-term evaluation of the risk of recurrence after cerebral sinus-venous thrombosis. Circulation. 2010;121(25):2740-6.

Bushnell C, Saposnik G. Evaluation and management of cerebral venous thrombosis. Continuum (Minneap Minn). 2014;20(2 Cerebrovascular Disease):335-51.

Avsenik J, Oblak JP, Popovic KS. Non-contrast computed tomography in the diagnosis of cerebral venous sinus thrombosis. Radiol Oncol. 2016;50(3):263-8.

Kumar DAK. Role of MRI in Evaluation of Cerebral Venous Thrombosis. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS). 2018;17(6).

Daghighi MH, Poureisa M, Safarpour M, Behzadmehr R, Fouladi DF, Meshkini A, et al. Diffusion-weighted magnetic resonance imaging in differentiating acute infectious spondylitis from degenerative Modic type 1 change; the role of b-value, apparent diffusion coefficient, claw sign and amorphous increased signal. Br J Radiol. 2016;89(1066):20150152.

Daghighi MH, Golestani S, Taheraghdam A. Comparison of Diagnostic Value of MRI and MRV with MRI/MRV Combination in Cerebral Venous Thrombosis. American Journal of Life Science Researches. 2016;4(1).

Prochazka V, Rajner J, Prochazka M, Dvorak J, Cizek V. Oral contraceptive induced cerebral venous thrombosis treated by local catheter directed thrombolysis. Interv Neuroradiol. 2004;10(4):321-8.

Amoozegar F, Ronksley PE, Sauve R, Menon BK. Hormonal contraceptives and cerebral venous thrombosis risk: a systematic review and meta-analysis. Front Neurol. 2015;6:7.

Xu F, Liu C, Huang X. Oral contraceptives caused venous sinus thrombosis complicated with cerebral artery infarction and secondary epileptic seizures: A case report and literature review. Medicine (Baltimore). 2017;96(51):e9383.

Linn J, Pfefferkorn T, Ivanicova K, Muller-Schunk S, Hartz S, Wiesmann M, et al. Noncontrast CT in deep cerebral venous thrombosis and sinus thrombosis: comparison of its diagnostic value for both entities. AJNR Am J Neuroradiol. 2009;30(4):728-35.

Foroughipoor M, Ahmadi AM, Fadaei S, Moghaddam KR, Razavi AS. Causes of Cerebral Venous Thrombosis and its Clinical Manifestation in Patients Admitted in Emergency Unit and Neurology Ward of Ghaem Hospital. 2013.

Cumurciuc R, Crassard I, Sarov M, Valade D, Bousser MG. Headache as the only neurological sign of cerebral venous thrombosis: a series of 17 cases. J Neurol Neurosurg Psychiatry. 2005;76(8):1084-7.

Wasay M, Kojan S, Dai AI, Bobustuc G, Sheikh Z. Headache in Cerebral Venous Thrombosis: incidence, pattern and location in 200 consecutive patients. J Headache Pain. 2010;11(2):137-9.

Botta R, Donirpathi S, Yadav R, Kulkarni GB, Kumar MV, Nagaraja D. Headache Patterns in Cerebral Venous Sinus Thrombosis. J Neurosci Rural Pract. 2017;8(Suppl 1):S72-S7.

Tang PH, Chai J, Chan YH, Chng SM, Lim CC. Superior sagittal sinus thrombosis: subtle signs on neuroimaging. Ann Acad Med Singapore. 2008;37(5):397-401.




DOI: https://doi.org/10.22037/icnj.v6i1.23685

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