Abstract

Cerebral venous thrombosis (CVT) entails imperative diagnosis since it requires urgent anticoagulation and thrombolytic treatment to reduce morbidity and mortality. Conventional MRI sequences are often depended upon for early diagnosis and treatment of CVT. There is, however, variation in signal intensity depending on CVT phases which need to be comprehended for accurate diagnosis. Objective: To compare diagnostic efficacy of MRI sequences in detection of acute-subacute CVT using phase contrast magnetic resonance venography (PC-MRV) as reference standard. Materials and Methods: A retrospective case-control study was done including 72 patients with partial or complete CVT on PC-MRV and 34 control patients with normal MRI findings. MRI sequences including T1WI, T2WI, FLAIR, DWI and SWI were analyzed. Sensitivity and specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) for all sequences were determined separately and collectively. Results: Out of 72 cases, acute-early subacute CVT was present in 47.2% (group 1) and late subacute CVT was present in 52.8% patients (group 2). SWI had highest sensitivity, accuracy and NPV in group 1 (87.9%, 91.4%, 77.3%; respectively) followed by T1WI (83.1%, 82.1%, 65.8%; respectively). Both DWI and SWI had highest specificity and PPV in group 1. In group 2, T1WI, T2WI, FLAIR and SWI had high sensitivity, T1WI had highest accuracy and NPV and DWI had highest specificity and PPV. When all sequences were used collectively, they had highest sensitivity, accuracy and NPV in groups 1 and 2. Conclusion: Multiparametric MRI has high sensitivity and accuracy for acute- subacute CVT and can be advantageous for early detection of clots in clinically suspected patients

Description