HAL will be down for maintenance from Friday, June 10 at 4pm through Monday, June 13 at 9am. More information
Skip to Main content Skip to Navigation
Journal articles

Value of spontaneous hyperdensity of cerebral venous thrombosis on helical CT

Abstract : BACKGROUND: Excluding a cerebral venous thrombosis (CVT) through imaging is a frequent request in the emergency setting. This assessment often starts by an unenhanced brain computed tomography (CT). PURPOSE: Re-evaluate the value of spontaneous hyperdensity of CVT on helical unenhanced brain CT. METHODS: Multicentric retrospective study on CVT probability based on visual assessment of spontaneous hyperdensity of cerebral venous system, performed by four blinded radiologists, individually then collectively, on a population including 14 helical unenhanced brain CTs with CVT and 102 unenhanced brain CTs without CVT (all confirmed by CT or magnetic resonance [MR] venography). Exclusion criteria: no DICOM image, symptoms >15 days, CVT indirect signs on unenhanced CT. A fifth radiologist set 768 regions of interest to measure and to compare the density within the normal venous sinuses and the CVTs. RESULTS: After consensus reading, sensitivity of this sign for CVT diagnosis was 100%, specificity 95.1%, and negative predictive value (NPV) 100%, with high individual NPV (99-100%). Area under the receiver-operating characteristic curve was 0.992 after consensus (0.976-0.986 individually). The spontaneous density was significantly different (P <0.05) between normal sinuses and CVTs, with a density >70 HU reported only within the CVTs, except for the horizontal part of the superior sagittal sinus (hSSS). CONCLUSION: The dense triangle sign on helical unenhanced brain CT has an excellent NPV to exclude a sinus thrombosis during the first 2 weeks. However, we believe that visual assessment of spontaneous hyperdensity is not sufficient for the diagnosis of CVT, with possible false-positive of the hSSS on unenhanced CT.
Document type :
Journal articles
Complete list of metadata

Contributor : Ghislaine Calvez Connect in order to contact the contributor
Submitted on : Wednesday, January 22, 2014 - 1:13:25 PM
Last modification on : Friday, April 1, 2022 - 3:10:44 AM



Marc Garetier, Jean Rousset, Ernesto Pearson, Valentin Tissot, Jean-Christophe Gentric, et al.. Value of spontaneous hyperdensity of cerebral venous thrombosis on helical CT. Acta Radiologica, SAGE Publications, 2013, epub ahead of print. ⟨10.1177/0284185113513977⟩. ⟨hal-00934623⟩



Record views