VALUE OF NON-CONTRAST CT AND VENOUS DENSITY MEASUREMENT IN THE DIAGNOSIS OF CEREBRAL VENOUS THROMBOSIS: A CASE-CONTROL STUDY

Cerebral venous thrombosis (CVT) is relatively uncommon but important. Because of non-specific signs and symptoms, non-contrast computed tomography (NCT) is performed for most patients. The first aim of this study was to investigate the sensitivity and specificity of NCT in the diagnosis of CVT. Another aim was to assess the value of sinus venous attenuation measurement on NCT in the diagnosis of CVT.

NCT of 187 patients were reviewed. Sensitivity and specificity of NCT were evaluated in the diagnosis of CVT. Hounsfield unit (HU) of sinus venous with thrombus was compared to normal veins of control group, with and without standardization to the average HU of the internal carotids.

CVT was confirmed in 32 patients by MRV (Magnetic Resonance Venography(. NCT has high sensitivity and specificity in the diagnosis of CVT. A significant difference in average venous sinus attenuation was found between thrombus in patients with CVT (66.12±7.4 HU) and normal veins in the control group (48.59±5.91 HU; p<0.05). A similar difference is identified between standardized HU value in venous sinuses with thrombus (1.59±0.24) and venous sinuses without thrombus (1.06±0.14; p<0.05). A HU of >62 and a standardized HU of >1.4 on NCT are associated with high probability of CVT.

High sensitivity of NCT and using sinus venous attenuation can be helpful for the early diagnosis and treatment of CVT in the emergency settings. Sinus venous attenuation value of >62 and standardized HU of >1.4 on NCT can be used as reliable methods to detect CVT.