AI Article Synopsis
- Clinical suspicion of cerebral venous sinus thrombosis (CVST) is often unclear because symptoms like headaches are non-specific, prompting a study to evaluate the diagnostic usefulness of nonenhanced CT (neCT) for this condition.
- In a review of 104 patients with nontraumatic headaches suspected of having CVST, only one case showed a potential thrombus on neCT, which was confirmed with CT venography (CTV); the rest did not have CVST, though 11% had other findings explaining their symptoms.
- The study suggests that while CVST is rarely detected in these patients using neCT, identifying high attenuation in dural sinuses can help in confirming diagnoses with CTV, indicating the need for radiologists to maintain a
Article Abstract
Background: Clinical suspicion of cerebral venous sinus thrombosis (CVST) is imprecise due to non-specific symptoms such as headache. The aim was to retrospectively assess the diagnostic value of nonenhanced CT (neCT) in patients with nontraumatic headache and clinically suspected CVST.
Methods: A retrospective consecutive series of patients referred 2013-2015 for radiology were evaluated. Eligible patients had nontraumatic headache and suspicion of CVST stated in the referral, investigated with CT venography (CTV) and nonenhanced CT (neCT). neCT scans were re-evaluated for the presence of CVST or other pathology. All CTVs were checked for the presence of CVST. The validation cohort consisted of 10 patients with nontraumatic CVT (2017-2019).
Results: Less than 1% (1/104) had a suspected thrombus on neCT, confirmed by subsequent CTV. The remaining 99% had a CTV excluding CVST. Eleven percent had other imaging findings explaining their symptoms. In the patient with CVST, the thrombosed dural sinus was high attenuating (maximum HU 89) leading to the suspicion of CVST confirmed by CTV. The validation cohort (n = 10) confirmed the presence of a high attenuating (HU > 65) venous structure in the presence of a confirmed thrombus in all patients presenting within 10 days (suspicion written in referral, 10%).
Conclusions: Despite clinical suspicion, imaging findings of CVST in nontraumatic headache are uncommon. Evaluating neCT for high attenuation in dural sinuses, followed by CTV for confirmation in selected cases seems reasonable. CVST should be recognized by all radiologists and requires a high level of awareness when reading neCT for other indications.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045590 | PMC |
| http://dx.doi.org/10.1186/s12880-020-00426-x | DOI Listing |
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