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Magnetic Resonance Imaging Combined with Intravenous Angiography in the Diagnosis of Cerebral Venous Sinus Thrombosis Value

Author: HaoShaoJiang
Tutor: HouYuLi
School: Shanxi Medical
Course: Neurology
Keywords: Cerebral venous sinus thrombosis MRI MRV DSA analysis
CLC: R743.3
Type: Master's thesis
Year: 2011
Downloads: 87
Quote: 0
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Abstract


Objective:Of magnetic resonance imaging combined magnetic resonance imaging veinsof the cerebral venous sinus thrombosis diagnostic value;Methods:Through the collection from January 2004 to December 2010 of ShanxiMedical University, First Clinical College, Department of Neurology, suspected cerebral venoussinus thrombosis were enrolled; It must meet the following conditions: first, did MRI and MRVexamination done within a week after its through digital subtraction angiography (DSA)inspection; its findings as the gold standard DSA, cerebral venous sinus thrombosis exists for thecase group, no thrombus for the control group there were statistical MRI and DSA, MRV andDSA, MRI combined with MRV and DSA diagnosis of Cerebral venous sinuses (superiorsagittal sinus, lateral sinus) thrombosis, and to list the tables from comparative analysis, thecorresponding results.Results:Under the selected conditions, a total of 85 patients eligible. In the 85 patients,DSA diagnosis of cerebral venous sinus thrombosis in 46 cases ,cerebral venous sinusthrombosis has not in 39 cases, MRI diagnosis of cerebral venous sinus thrombosis, 45 cases,MRV diagnosis of cerebral venous sinus thrombosis There are 47 cases, MRI diagnosis ofcerebral venous sinus MRV combined thrombosis, 50 cases in which DSA diagnosis of superiorsagittal sinus (SSS) thrombosis, 30 cases of lateral sinus (LS) < transverse sinus(TS), sigmoidsinus(SS)> are 26 cases of thrombosis; MRI diagnosis of superior sagittal sinus thrombosis in 31cases, 25 cases of lateral sinus thrombosis; MRV diagnosed 30 cases of superior sagittal sinusthrombosis, lateral sinus thrombosis in 27 cases, MRI diagnosis of joint MRV 32 cases ofsuperior sagittal sinus thrombosis, 28 cases of lateral sinus thrombosis.1. On cerebral venous sinuses (superior sagittal sinus, lateral sinus, etc.) to analyze bloodclots: (1) MRI and DSA diagnosis of cerebral venous sinuses (superior sagittal sinus, lateralsinus, etc.) thrombosis compared the results obtained: sensitivity, false negative rate, specificity,false positive rate, Youden index were 91.3%,8.7%, 92.3%,7.7%,0.836, compliance rate andpositive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio were 91.7%,93.3%,90.0%,11.857,0.094, Kappa value is 0.833; (2) MRV and DSAdiagnosis of cerebral venous sinus (superior sagittal sinus, lateral sinus, etc.) thrombosiscompared the results obtained: sensitivity, false negative rate, specificity, false positive rate,Youden index were 93.5%,6.5%,89.7%,10.3%,0.832, consistent, positive predictive value,negative predictive value, positive likelihood ratio, negative likelihood ratio were91.8%,91.5%,92.1%,9.078,0.072, Kappa value is 0.835; (3) MRI combined with MRV andDSA diagnosis of cerebral venous sinus (superior sagittal sinus, lateral sinus, etc.) thrombosiscompared the results obtained: sensitivity, false negative rate, specificity, false positive rate,Youden index were 97.8%,2.2%,87.2%,12.8%,0.850, consistent, positive predictive value,negative predictive value, positive likelihood ratio, negative likelihood ratio were92.9%,90.0%,97.1%,7.641,0.025,Kappa value is 0.856.2. On the analysis of the superior sagittal sinus thrombosis: (1) MRI and DSA diagnosisof superior sagittal sinus thrombosis compared the results obtained: sensitivity, false negativerate, specificity, false positive rate, Youden index were 96.7%, 3.3%, 94.9%, 5.1%, 0.916,compliance rate and positive predictive value and negative predictive values, positive likelihoodratio, negative likelihood ratio were 95.7%, 93.5%,, 97.4%, 18.961,0.035, Kappa values is 0.912;(2) MRV and DSA diagnosis of superior sagittal sinus thrombosis compared the results obtained:sensitivity, false negative rate, specificity, false positive rate, Youden index were 90.0%, 10.0%,92.3%, 7.7 %, 0.823, compliance rate and positive predictive value, negative predictive value,positive likelihood ratio, negative likelihood ratio were 91.3%, 90.0%, 92.3%, 11.688,0.108,Kappa value is 0.823; (3) MRI combined with MRV and DSA diagnosis of the superior sagittalsinus thrombosis compared the results obtained: sensitivity, false negative rate, specificity, falsepositive rate, Youden index were 96.7%, 3.3%, 92.3%, 7.7%, 0.890, in line with the rate positivepredictive value, negative predictive value, positive likelihood ratio, negative likelihood ratiowere 94.2%, 90.6%, 97.3%, 12.558,0.036, Kappa value is 0.883.3. Lateral sinus (transverse sinus, sigmoid sinus) thrombosis were analyzed: (1) MRI andDSA diagnosis of lateral sinus (transverse sinus, sigmoid sinus) thrombosis compared the resultsobtained: sensitivity, false negative rate and specificity false positive rate, Youden index were80.8%,19.2%,89.7%,10.3%,0.705, compliance rate and positive predictive value, negativepredictive value,positive likelihood ratio, negative likelihood ratio were 86.2%, 84.0%, 87.5%,7.845,0.214, Kappa value is 0.711; (2) MRV and DSA diagnosis of lateral sinus (transverse sinus,sigmoid sinus) thrombosis compared the results obtained: sensitivity, false negativerate,specificity, false positive rate, Youden index were 88.5%,11.5%,89.7%,10.3%,0.782,compliance rate and positive predictive value, negative predictive value, positive likelihood ratio,negative likelihood ratio were 89.2%,85.2%,92.1%,8.592,0.128, Kappa value is 0.776; (3) MRI combined with MRV and DSA diagnosis of lateral sinus (transverse sinus, sigmoid sinus)thrombosis compared the results obtained: sensitivity, false negative rate,specificity,falsepositive rate,Youden index were 88.5%,11.5%,87.2%,12.8%,0.757,compliance rate and positivepredictive value,negative predictive value,positive likelihood ratio, negative likelihood ratiowere 87.7%,82.1%,91.9%, 6.914,0.132, Kappa value is 0.747.ConclusioConclusion1, MRI examination alone can diagnose superior sagittal sinus thrombosis;2, MRV examination alone can diagnose lateral sinus (transverse sinus, sigmoid sinus)thrombosis;3,MRI combined with MRV diagnosis of cerebral venous sinus thrombosis may replaceDSA.

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CLC: > Medicine, health > Neurology and psychiatry > Neurology > Cerebrovascular disease > Acute cerebrovascular disease ( stroke)
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