The Value Of CTV In Diagnosis And Follow-up For Patients With CVST

Purpose: This study aimed to analyze the value of CTV in the diagnosis and follow-up for patients with cerebral venous sinus thrombosis(CVST)and designed a novel semi-quantitative CTV-based scoring instrument-the Venous Occlusion Image Score(VOIS),and studied its value in clinical practice.On this basis,VOIS was applied in the original research for the change of CVST pre-and post-treatment.Methods:The VOIS divided the major cerebral venous sinuses and internal jugular veins into nine parts.CT venography and DSA source images were extracted from the database,then interpreted and scored independently by a panel of three reviewers according to VOIS.Inter-observer agreement was determined using the intraclass correlation coefficient(ICC)and Kappa coefficient(κ).The specificity,sensitivity,and accuracy of CTV in the diagnosis of CVST were calculated with DSA as the gold standard.Disease severity at admission and follow-up were evaluated by the National Institutes of Health Stroke Scale(NIHSS)and modified Rankin Scale(m RS).Logistic regression was applied to assess the association between VOIS and the primary outcomes.Results:Fifty-six patients with CVST were included in the study.For7 patients who underwent cerebral CTV and DSA,interobserver agreements among reviewers were 0.94(95%CI=0.79-0.99,P<0.001)and 0.98(95%CI=0.92-0.99,P<0.001)respectively,indicating VOIS is a reliable scoring tool.The κ coefficient of agreement for the two radiology measures was 1.0(P=0.008),indicating the consistency between CTV and DSA in the diagnosis of CVST is high.With DSA as the gold standard,the accuracy of CTV in the diagnosis of CVST was 85.7-100%,indicating CTV is a reliable diagnostic method for CVST.Logistic regression analysis shows,when VOIS≤5,the risk of acquiring unfavorable prognosis significantly increased(OR=5.98,95%CI=1.04-10.31,P<0.05).Conclusion: CTV is a rapid,reliable screening method for CVST,which is suitable for diagnosis in emergency settings and follow-up after treatment.Besides,Venous Occlusion Image Score can be used to evaluate the condition of CVST patients and predict the prognosis.