Accuracy of unenhanced CT in the diagnosis of cerebral venous sinus thrombosis
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COMPUTED TOMOGRAPHY
Accuracy of unenhanced CT in the diagnosis of cerebral venous sinus thrombosis Matteo Bonatti1 · Riccardo Valletta1,2 · Fabio Lombardo3 · Giulia A. Zamboni2 · Emanuela Turri4 · Giacomo Avesani5 · Giancarlo Mansueto2 · Riccardo Manfredi5 · Günther Schifferle1 Received: 22 October 2019 / Accepted: 12 August 2020 © Italian Society of Medical Radiology 2020
Abstract Objectives To evaluate the diagnostic performance of unenhanced brain CT (NECT) in identifying patients with cerebral venous sinus thrombosis (CVT). Methods Forty-eight consecutive patients with CVT and 48 healthy controls were included in our retrospective study. All patients underwent NECT and CT/MR angiography within 24 h. Two radiologists independently evaluated NECT images for the presence of sinus hyperdensity; discrepancies were solved by consensus. Sinus attenuation was measured in seven sites. The obtained data were compared with the presence of CVT at CT/MR angiography and with patients’ hematocrit. Results Interobserver agreement in sinus hyperdensity detection was good (k = 0.64). The presence of sinus hyperdensity at NECT enabled to detect patients with CVT with 81% sensitivity, 77% specificity, 78% PPV, and 80% NPV. Mean attenuation was significantly higher in sinus segments involved by CVT than in patent ones (62.4 ± 10 versus 55.6 ± 6 HU, p
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