Objective: To assess the ability of unenhanced computed tomography (CT) for diagnosis of acute abdominal venous thrombosis (VT).
Method: This retrospective study matched 29 patients with 52 VT with a control group of 29 patients without VT. Two radiologists independently evaluated the unenhanced CT on standard abdominal and narrowed window settings to detect acute VT by anatomical location and confidence level. The effect of age, sex, hemoglobin, and hematocrit on VT density (HU) was also evaluated.
Results: Overall sensitivity, specificity, and accuracy were 77.9% (95% CI, 66%-85%), 96.7% (95% CI, 94%-98%), and 95.4% (95% CI, 93%-96%), respectively, in the detection of VT, with improved sensitivity and confidence ratings on narrowed windows. Mean VT density (Hounsfield unit) was positively associated with hemoglobin and hematocrit and significantly higher than background blood (67.2 vs 37.0; P < 0.0001).
Conclusion: Acute abdominal VT can be detected on unenhanced CT in more than two thirds of the cases by identifying hyperdense venous segments.