Linn J, Ertl-Wagner B, Seelos K C, Strupp M, Reiser M, Brückmann H, Brüning R
Department of Neuroradiology, University Hospital Munich, Grosshadern, Munich, Germany.
AJNR Am J Neuroradiol. 2007 May;28(5):946-52.
The diagnosis of cerebral venous and sinus thrombosis (CVST) as a rare but important cause of stroke is challenging. We aimed to investigate the diagnostic value of multidetector-row CT angiography (MDCTA) as a fast and cost-effective imaging tool in diagnosing CVST.
Nineteen patients who presented with clinical symptoms of a possible CVST were included. All patients had received both MDCTA and MR imaging with venous MR-angiography. Three blinded readers were asked to identify the cerebral sinuses and veins in MDCTA and to evaluate the presence of CVST in MDCTA. Consensus reading with interpretation of the MR imaging served to establish the definite diagnosis.
The consensus reading revealed CVST in 10 of the 19 patients. With MDCTA, the venous sinuses could be identified in 99.2% and the cerebral veins in 87.6% of cases. The sensitivity and specificity of MDCTA for the diagnosis of CVST were 100%.
Our study demonstrates that MDCTA provides excellent sensitivity and specificity for the diagnosis of CVST. Further studies are needed to evaluate the diagnostic potential of MDCTA in specific subsets of the general entity of CVST such as cortical venous thrombosis, thrombosis of the cavernous sinus, and thrombosis of the internal cerebral veins.
脑静脉窦血栓形成(CVST)作为一种罕见但重要的卒中病因,其诊断具有挑战性。我们旨在研究多排螺旋CT血管造影(MDCTA)作为一种快速且经济高效的成像工具在诊断CVST中的价值。
纳入19例出现可能为CVST临床症状的患者。所有患者均接受了MDCTA及静脉磁共振血管造影的磁共振成像检查。三位不知情的阅片者被要求在MDCTA上识别脑静脉窦和静脉,并评估MDCTA中CVST的存在情况。结合磁共振成像解读的一致性阅片用于确立明确诊断。
一致性阅片显示19例患者中有10例存在CVST。在MDCTA检查中,99.2%的病例可识别静脉窦,87.6%的病例可识别脑静脉。MDCTA诊断CVST的敏感性和特异性均为100%。
我们的研究表明,MDCTA对CVST的诊断具有极高的敏感性和特异性。需要进一步研究来评估MDCTA在CVST总体特定亚组中的诊断潜力,如皮质静脉血栓形成、海绵窦血栓形成和大脑内静脉血栓形成。