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Thromb Haemost 2018; 118(06): 1067-1077
DOI: 10.1055/s-0038-1642636
Stroke, Systemic or Venous Thromboembolism
Schattauer GmbH Stuttgart

The Performance of CT versus MRI in the Differential Diagnosis of Cerebral Venous Thrombosis

Weilin Xu
1   Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
,
Liansheng Gao
1   Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
,
Tao Li
1   Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
,
Neha Darshana Ramdoyal
2   School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
,
Jianmin Zhang
1   Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
3   Brain Research Institute, Zhejiang University, Hangzhou, Zhejiang, China
4   Collaborative Innovation Center for Brain Science, Zhejiang University, Hangzhou, Zhejiang, China
,
Anwen Shao
1   Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
› Author Affiliations
Funding This work was funded by China Postdoctoral Science Foundation (2017M612010) and National Natural Science Foundation of China (81701144).
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Publication History

08 June 2017

21 March 2018

Publication Date:
25 April 2018 (online)

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Abstract

Background Cerebral venous thrombosis (CVT) is a rare disease, and with poor prognosis. Computed tomography (CT) and magnetic resonance imaging (MRI) are the most commonly used image modalities for patients with non-specific neurologic symptoms. We present here a meta-analysis to assess the accuracy of CT and MRI in the differential diagnosis of CVT and cerebral venous sinus thrombosis (CVST).

Materials and Methods A comprehensive search of the PubMed, EMBASE, Web of Science, Cochrane Database and Chinese Biomedical (CBM) databases was conducted prior to March 20, 2017. In this report, we assess the methodological quality of each article individually and perform a meta-analysis to obtain the summary of the diagnostic accuracy of CT and MRI in correctly identifying CVT and CVST.

Results Twenty-four eligible articles comprising 48 studies (4,595 cases) were included. The pooled sensitivity for CT–CVT/CT–CVST groups is 0.79 (95% confidence interval [CI]: 0.76, 0.82)/0.81(95% CI: 0.78, 0.84), and pooled specificity is 0.90 (95% CI: 0.89, 0.91)/0.89 (0.88, 0.91), with an area under the curve (AUC) for the summary receiver operating characteristic (SROC) of 0.9314/0.9161, respectively. No significant heterogeneity and publication bias was observed across each study. For MRI–CVT/MRI–CVST, the pooled sensitivity is 0.82 (95% CI: 0.78, 0.85)/0.80 (95% CI: 0.76, 0.83), and pooled specificity is 0.92 (95% CI: 0.91, 0.94)/0.91(0.89, 0.92), with an AUC for the SROC of 0.9221/0.9273, respectively.

Conclusion This meta-analysis indicates that both CT and MRI have a high level of diagnostic accuracy in the differential diagnosis of CVT and CVST, independent of stage, target for analysis or analysis methods. They could be chosen as alternative sub-optimal gold standards for diagnosing CVT and CVST, especially in emergency.

Keywords

computed tomography - magnetic resonance imaging - sinus thrombosis - intracranial - intracranial thrombosis

Note

Weilin Xu, Liansheng Gao and Tao Li have equally contributed to this work as co-first authors. Jianmin Zhang and Anwen Shao have equally contributed to this work as corresponding authors.


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