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评估多排脑 CT 血管造影在诊断急性脑静脉血栓形成中的诊断价值。

Evaluating the diagnostic value of multi-detector brain CT angiography in diagnosing acute cerebral venous thrombosis.

机构信息

Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Student Research Committee, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran.

出版信息

Sci Rep. 2022 Nov 4;12(1):18685. doi: 10.1038/s41598-022-21743-x.

Abstract

Cerebral venous sinus thrombosis (CVST) is a rare type of venous thromboembolism mostly affecting young adults. Despite improved imaging studies, the diagnosis is usually delayed by several days. An average diagnostic delay of seven days from the onset of symptoms is still reported for this condition, and it is crucial for radiologists to detect this potentially lethal condition in routine imaging studies. In this study we aimed to investigate the diagnostic value of multi-detector brain CTA in diagnosing acute CVT. We searched our Picture Archiving and Communicating System (PACS) of our tertiary-level academic hospital between March 2016 and March 2019, and collected all patients for whom both contrast-enhanced MRV and brain CTA were acquired at the same admission. A total of 242 patients were found on our PACS database who met our criteria. In the blinded multidetector-row computed tomographic angiography (MDCTA) evaluation, there was a sensitivity of 96.1%, specificity of 98.6% and accuracy of 98.3% for MDCTA in detecting CVST. In the emergency settings, and in centers in which MRI scanners are not available, MDCTA can be used instead of CE-MRV for diagnosis of CSVT with a good sensitivity and specificity.

摘要

脑静脉窦血栓形成(CVST)是一种罕见的静脉血栓栓塞症,主要影响年轻人。尽管影像学研究有所改善,但诊断通常仍会延迟数天。对于这种疾病,平均诊断延迟时间为症状出现后 7 天,因此对于放射科医生来说,在常规影像学研究中检测这种潜在致命疾病至关重要。在本研究中,我们旨在探讨多排脑 CT 血管造影(MDCTA)在诊断急性 CVT 中的诊断价值。我们检索了我们的三级学术医院的图片存档与通信系统(PACS),并在 2016 年 3 月至 2019 年 3 月期间收集了所有在同一入院时同时进行对比增强 MRV 和脑 CTA 的患者。在我们的 PACS 数据库中发现了 242 名符合我们标准的患者。在多排 CT 血管造影(MDCTA)的盲法评估中,MDCTA 检测 CVST 的敏感性为 96.1%,特异性为 98.6%,准确性为 98.3%。在紧急情况下,以及在没有 MRI 扫描仪的中心,MDCTA 可用于诊断 CSVT,具有良好的敏感性和特异性,可替代 CE-MRV。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd5f/9636138/5ba752db6ae4/41598_2022_21743_Fig1_HTML.jpg

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