PT  - JOURNAL ARTICLE
AU  - A. Hakim
AU  - C. Kurmann
AU  - K. Pospieszny
AU  - T.R. Meinel
AU  - M.A. Shahin
AU  - M.R. Heldner
AU  - R. Umarova
AU  - S. Jung
AU  - M. Arnold
AU  - M. El-Koussy
TI  - Diagnostic Accuracy of High-Resolution 3D T2-SPACE in Detecting Cerebral Venous Sinus Thrombosis
AID  - 10.3174/ajnr.A7530
DP  - 2022 May 26
TA  - American Journal of Neuroradiology
4099  - http://www.ajnr.org/content/early/2022/05/26/ajnr.A7530.short
4100  - http://www.ajnr.org/content/early/2022/05/26/ajnr.A7530.full
AB  - BACKGROUND AND PURPOSE: Assessment of cerebral venous sinus thrombosis on MR imaging can be challenging. The aim of this study was to evaluate the diagnostic accuracy of high-resolution 3D T2 sampling perfection with application-optimized contrasts by using different flip angle evolution (SPACE) in patients with cerebral venous sinus thrombosis and to compare its performance with contrast-enhanced 3D T1-MPRAGE.MATERIALS AND METHODS: We performed a blinded retrospective analysis of T2-SPACE and contrast-enhanced MPRAGE sequences from patients with cerebral venous sinus thrombosis and a control group. The results were compared with a reference standard, which was based on all available sequences and clinical history. Subanalyses were performed according to the venous segment involved and the clinical stage of the thrombus.RESULTS: Sixty-three MR imaging examinations from 35 patients with cerebral venous sinus thrombosis and 51 examinations from 40 control subjects were included. The accuracy, sensitivity, and specificity calculated from the initial MR imaging examination for each patient were 100% each for T2-SPACE and 95%, 91%, and 98%, respectively, for contrast-enhanced MPRAGE. The interrater reliability was high for both sequences. In the subanalysis, the accuracy for each venous segment involved and if subdivided according to the clinical stage of thrombus was ≥95% and ≥85% for T2-SPACE and contrast-enhanced MPRAGE, respectively.CONCLUSIONS: Both T2-SPACE and contrast-enhanced MPRAGE offer high accuracy for the detection and exclusion of cerebral venous sinus thrombosis; however, T2-SPACE showed a better overall performance and thus could be a useful tool if included in a multiparametric MR imaging protocol for the diagnosis of cerebral venous sinus thrombosis, especially in scenarios where gadolinium administration is contraindicated.CEcontrast-enhancedCVSTcerebral venous sinus thrombosisSPACEsampling perfection with application-optimized contrasts using different flip angle evolution