Study On Cerebral Vein And Sinus Thrombosis With Magnetic Resonance Venography

Objective1. The purpose of our study is to prospectively investigate the diagnostic value of3D CE-MRV and2D TOF-MRV in the evaluation of the diffrent stage and the recanalization of CVST compared with DSA.2Analyze the relationship between the location and extent of sinus thrombosis and presence and severity of brain lesions.Methods1.Through the collection from January2008to December2011of Department of Neurosurgery, Fuzhou General Hospital,15patients suspected CVST were prospectively recruited into this study;Diagnostic accuracy of2D-TOF MRV and3D CE-MRV in the detection of the diffrent stage and recanalized thrombus was evaluated using DSA as the reference standard.2.Retrospective chart and neuroimaging review of patients with documented CVST. A CVST score was devised to quantify the extent of cerebral venous sinus thrombosis and severity of brain lesions, to Analyze the relationship between the location and extent of sinus thrombosis and presence and severity of brain lesions.Results1. Compared with2D TOF-MRV,3D CE-MRV provides high sensitivity, specificity,positive predictive value, negative predictive value, Kappa value in diagnosis of acute and subacute CVST.2.3D CE-MRV and DSA diagnosis of chronic CVST compared the results obtained:sensitivity, specificity,positive predictive value, negative predictive value, Kappa value were69.44%98.15%,92.59%,90.60%,73.73%.3.2D TOF-MRV and DSA diagnosis of chronic CVST compared the results obtained:sensitivity, specificity, positive predictive value, negative predictive value, Kappa value were69.44%98.15%,92.59%,90.60%,73.73%.4.The sensitivity, specificity, positive predictive value, and negative predictive, Kappa value of3D CE-MRV for the detection of recanalization on a segmental basis were81.82%,71.88%,50.0%,92.0%and44.42%respectively.5.The sensitivity, specificity, positive predictive value, and negative predictive, Kappa value of2D-TOF MRV for the detection of recanalization on a segmental basis were60.0%,100%,100%,86.67%,and52.63%respectively.6.30of42(71.4%) patients had brain lesions. The extent of sinus thrombus was associated with increased risk of brain lesions.Brain lesions There are some certain degree of regularity between site of the CVST to the distribution of parenchymal lesions; Age, sex, and acquired or hereditary thrombophilias were not associated with the risk of parenchymal lesions. The extent of the Brain lesions correlates with the outcome in patients with CVST。Conclusion1. Compared with2D TOF-MRV, the3D CE-MRV provides high sensitivity and specificity for the diagnosis of non-chronic CVST, it almost has the same diagnostic value Compared with DSA; Compared with3D CE-MRV,2D-TOF MRV provides high agreement for the diagnosis of chronic CVST and recanalized CVST segments.3D CE-MRV should be we first selection for the diagnosis of non-chronic CVST. The use of CE-MRV together with the TOF reduces the level of missed recanalized segments but if used independently may suffer from reduced specificity due to thrombus enhancement.2. The extent of the sinus involvement correlates with the risk of brain lesions in patients with CVST, but additional factors might also contribute to their occurrence. There are ome certain degree of regularity between site of the CVST to the distribution of parenchymal lesions. The extent of the Brain lesions correlates with the outcome in patients with CVST。...