Cortical vein thrombosis: The diagnostic value of different imaging modalities

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Jennifer Linn - , Hospital of the Ludwig-Maximilians-University (LMU) Munich, Ludwig Maximilian University of Munich (Author)
  • Stefan Michl - , Ludwig Maximilian University of Munich (Author)
  • Bochmann Katja - , Ludwig Maximilian University of Munich (Author)
  • Thomas Pfefferkorn - , Ludwig Maximilian University of Munich (Author)
  • Martin Wiesmann - , Ludwig Maximilian University of Munich, Helios Hospital Group (Author)
  • Sabine Hartz - , Ludwig Maximilian University of Munich (Author)
  • Martin Dichgans - , Ludwig Maximilian University of Munich (Author)
  • Hartmut Brückmann - , Ludwig Maximilian University of Munich (Author)

Abstract

Introduction: Cortical vein thrombosis (CVT) is a rare disorder, and its diagnosis is challenging. The aim of our study was to evaluate the value of different imaging modalities for the detection of CVT. Methods: Thirteen patients with CVT, either isolated (n∈=∈3) or in combination with sinus thrombosis (n∈=∈10), and 20 control patients without any venous pathologies were included in this study. The analysis was performed independently by three blinded readers who evaluated the following imaging modalities and sequences separately: non-enhanced computed tomography (NCCT); multi-detector row CT angiography (MDCTA); diffusion-weighted (DWI), T1-weighted (T1w), PD-weighted (PDw), T2 -weighted (T2 w), and fluid-attenuated inversion recovery-weighted (FLAIRw) magnetic resonance (MR) sequences; as well as venous MR angiography (vMRA). The sensitivity, specificity, positive (PPV) and negative predictive values, and interobserver agreement of the different modalities were calculated. Results: T2 w showed the highest sensitivity for the detection of CVT (97.4%), followed by T1w (70%). FLAIRw and vMRA had a sensitivity of 50% and 41.7%, respectively, whereas the sensitivity of NCCT, MDCTA, DWI, and PDw was below 30%. The specificity and PPV of all modalities was 100%, with good to perfect interobserver agreement. Conclusion: T2 w was the superior MR imaging sequence for diagnosing CVT. Besides T2 w, only T1w reached a sensitivity of over 50% for CVT, followed by FLAIRw, and vMRA. On the contrary, our results suggest that NCCT but also MDCTA might not be suitable for diagnosing CVT.

Details

Original languageEnglish
Pages (from-to)899-911
Number of pages13
JournalNeuroradiology
Volume52
Issue number10
Publication statusPublished - Oct 2010
Peer-reviewedYes
Externally publishedYes

External IDs

PubMed 20107776

Keywords

Keywords

  • -weighted imaging, Cortical vein thrombosis, MRI, Multi-detector row CT angiography, T2