2.Cerebral venous sinus thrombosis: Comparison of multidetector computed tomography venogram (MDCTV) and magnetic resonance venography (MRV) of various fi eld strengths
Joo Siong Ho ; Kartini Rahmat ; Norlisah Ramli ; Farhana Fadzli ; Heng ThayChong ; Chong Tin Tan
Neurology Asia 2012;17(4):281-291
Objectives: To investigate the accuracy of multidetector computed tomography venography (MDCTV)
and magnetic resonance venography (MRV) of differing fi eld strength in diagnosing cerebral venous
sinus thrombosis (CVST). To assess the visualization rate of the cerebral veins and dural sinuses between
these imaging modalities. Methods: A retrospective review of 27 patients with clinical suspicion of
CVST who underwent both MDCTV and corresponding MRI/MRV brain scans at 0.35T, 1.5T or 3.0T
fi eld-strength were performed. Results were compared with the defi nitive fi nal diagnosis. In the nonthrombotic
group of patients, a descriptive study of the anatomical visualization of cerebral veins and
dural sinuses was also undertaken. Results: Ten of the 27 patients had a fi nal diagnosis of CVST. The
Neuroradiologists’ consensus reading identifi ed these 10 cases of CVST in both the MDCTV and MRV
scans with a sensitivity rate of 100%. There was one false positive in MDCTV and three false-positives
in the MRV group (1.5T) with positive predictive values of 90.9% and 76.9%, respectively. MDCTV
and MRV demonstrated a specifi city of 94.1% and 82.4%, respectively in diagnosing CVST. No false
negative images were seen demonstrating a negative predictive value of 100% in both modalities. There
was no statistical difference in the anatomical visualization rate of the cerebral veins or the dural sinuses
among the various strengths of MRI. However, statistically signifi cant (p<0.05) fewer visualised vessels
in MRV compared to MDCTV, for the SSS, ISS, straight sinus, ICV and VOG.
Conclusion: MDCTV is equal to MRV of various strength in its sensitivity for CVST diagnosis. MDCTV
also provides better anatomical visualization of the dural sinuses and cerebral veins.