R Kochhar1, N Khandelwal, P Singh, S Suri. 1. Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. kochhar_rohit@hotmail.com
Abstract
BACKGROUND: Various imaging findings of cerebral sino-venous thrombosis (CSVT) have been described on magnetic resonance venography (MRV). OBJECTIVE: The purpose of this study was to evaluate the significance of visualization of the arterial system on cerebral MRV, also described as arterial contamination, as an indirect sign of CSVT. METHODS: Forty patients with a clinical suspicion of venous sinus thrombosis underwent MR imaging of the brain, followed by MRV sequence, based on 2D time of flight technique in the coronal oblique plane. Patient's clinical symptoms and signs were noted with particular interest for papilloedema. Twenty-seven patients were diagnosed to have cerebral venous thrombosis on MRV, and of these, arterial contamination was visualized in 16 patients. In the remaining 13 cases, in which there was no evidence of venous sinus thrombosis, arterial contamination was absent. The sensitivity of this finding was 59.25% (n = 16/27), specificity was 100%, positive predictive value was 100% and negative predictive value was 54.2%. Of these 16 patients with arterial contamination, 12 patients had evidence of increased intracranial pressure in the form of papilloedema. CONCLUSION: Visualization of the arterial system is a useful indirect sign of CSVT, and may be an indicator of increased intracranial pressure in these patients.
BACKGROUND: Various imaging findings of cerebral sino-venous thrombosis (CSVT) have been described on magnetic resonance venography (MRV). OBJECTIVE: The purpose of this study was to evaluate the significance of visualization of the arterial system on cerebral MRV, also described as arterial contamination, as an indirect sign of CSVT. METHODS: Forty patients with a clinical suspicion of venous sinus thrombosis underwent MR imaging of the brain, followed by MRV sequence, based on 2D time of flight technique in the coronal oblique plane. Patient's clinical symptoms and signs were noted with particular interest for papilloedema. Twenty-seven patients were diagnosed to have cerebral venous thrombosis on MRV, and of these, arterial contamination was visualized in 16 patients. In the remaining 13 cases, in which there was no evidence of venous sinus thrombosis, arterial contamination was absent. The sensitivity of this finding was 59.25% (n = 16/27), specificity was 100%, positive predictive value was 100% and negative predictive value was 54.2%. Of these 16 patients with arterial contamination, 12 patients had evidence of increased intracranial pressure in the form of papilloedema. CONCLUSION: Visualization of the arterial system is a useful indirect sign of CSVT, and may be an indicator of increased intracranial pressure in these patients.