Abstract
Background: Cerebral venous and sinus thrombosis (CVT) is the rare type of stroke, which can be fatal or causes significant morbidity. CVT could cause by multiple etiologies and risk factors and could present with many signs and symptoms such as a headache, seizure or altered mental status. The gold standard for diagnosing CVT is magnetic resonance venography (MRV) or computed tomographic venography (CTV), as these modalities are not available in many health centers and the early diagnosis of this disease improves significantly the outcome of treatment, we evaluated the diagnostic values of CT and magnetic resonance imaging (MRI) in CVT patients. Methods: We compiled and investigated the radiological and clinical records of 92 patients with the final diagnosis of CVT; we observed the sign of thrombosis in 74 patients who had either the non-contrast CT or MRI plus MRV. We statistically analyzed the sensitivity, specificity, positive predictive value, negative predictive value, accuracy, the positive and negative likelihood ratio of these modalities. Results: Our results demonstrated that the sensitivity of CT scan is 60.5%, and its specificity is 66.7%. The positive predictive value of CT is 85%, and its negative predictive value is 34%. Our study demonstrated that the accuracy of CT in diagnosing CVT patients is 62%. Besides our results showed that the sensitivity of MRI in diagnosing CVT is 87%, and the specificity of MRI is 76.9%. Hence the positive predictive value of MRI is 94%, and the negative predictive value is 58%, and the accuracy of this modality is 85% Conclusion: In the absence of gold standard modalities, MRI and CT scan have relatively good diagnostic values, besides MRI is more beneficial between the two, moreover we found that CVT is more prevalent among women and in warm seasons.
Highlights
Cerebral venous thrombosis (CVT) and dural sinus thrombosis are rare types of brains strokes, which has a prevalence of 5 per 1 million and include about 0.5-1% of strokes
All patients presenting with the diagnostic criteria of Cerebral venous and sinus thrombosis (CVT), confirmed using noncontrast Computed tomography (CT) (NCCT) or magnetic resonance imaging (MRI), followed by magnetic resonance venography (MRV) or computed tomographic venography (CTV) included in our study, but 18 patients who did not have radiological images and reports of either CT, MRI or CTV, MRV or with low-quality images excluded from analysis
From 92 patients recorded with the diagnosis of CVT, 18 patients had been excluded in our imaging study, as they lacked either MRV or one of the modalities of CT or MRI, the radiologic images and reports of 74 patients with CVT, 52 female (70.3%) and 22 (29.7%) male, were investigated
Summary
Cerebral venous thrombosis (CVT) and dural sinus thrombosis are rare types of brains strokes, which has a prevalence of 5 per 1 million and include about 0.5-1% of strokes. CVT has various presentations; headache is the most frequent chief complaint in these patients. Cerebral venous and sinus thrombosis (CVT) is the rare type of stroke, which can be fatal or causes significant morbidity. The positive predictive value of MRI is 94%, and the negative predictive value is 58%, and the accuracy of this modality is 85% Conclusion: In the absence of gold standard modalities, MRI and CT scan have relatively good diagnostic values, besides MRI is more beneficial between the two, we found that CVT is more prevalent among women and in warm seasons.
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