Abstract TP54: Magnetic Resonance Black-blood Thrombus Imaging Could be a Promising New Tool in the Diagnosis of Cerebral Venous and Sinus Thrombosis

Abstract

Introduction: BTI is a novel 3D black-blood imaging technique with isotropic, submillimeter spatial resolution. As opposed to conventional methods that indirectly diagnose CVT by imaging the lumen, BTI directly visualizes the thrombus with suppressed blood signals. We aimed to prospectively evaluate the diagnostic performance of BTItechnique in patients with suspected cerebral venous and sinus thrombosis (CVT) as compared to MR venography. Materials and Methods: MR venography and BTI were performed using 3.0 T in consecutive patients suspected of CVT between August 2014 and October 2015. Signal to noise ratio (SNR) and contrast to noise ratio (CNR) were calculated for the detected thrombus on BTI. Diagnostic performance of BTI were analyzed on both per-segment and per-patient basis. Results: A total of 58 met study criteria Thrombus SNR was 206 ± 95 in acute thrombus and 94 ± 41 in chronic thrombus (P < 0.0001). Thrombus to lumen CNR was 201 ± 94 and 86 ± 40 for acute and chronic thrombus, respectively (P < 0.0001). The sensitivity and specificity rates of BTI in the detection of CVT were 97.3% (36/37, 95% confidence interval [CI] 85.8% to 99.9%) and 95.2% (20/21, 95% CI 76.2% to 99.9%), respectively on per patient level. On per segment level, the sensitivity and specificity were 95.6% (152/159, 95% CI 91.1% to 98.2%) and 98.0% (640/653, 95%CI 96.6% to 98.9%), respectively. The characteristics of the study population are summarized in Table 1. Figure 2 demonstrated thrombus volume quantification in one patient and total volume was 11.8cc. Conclusions: BTI allows for selective visualization of acute and chronic thrombus with high sensitivity, specificity and accuracy. Our findings suggest that BTI may emerge as a promising first line diagnostic imaging tool in the diagnosis of CVT. Figure 1. BTI images of a 13-year-old female with suspected acute CVT. Sagittal, coronal, and axial images of BTI depict the hyperintense signal of acute thrombi (A, B, and C) in ISS, Galen, SS, RSS, and RTS. Thrombus volume measurement was segmented and total thrombus volume was 11.8cc(D, E, and F). Table 1. Clinical Characteristics of 58 patients who underwent BTI