Characteristic Analysis And Diagnostic Value Of HRMR-VWI For Cerebral Venous Sinus Thrombosis

Objective:To evaluate the diagnostic coincidence rate and thrombotic signal characteristics of cerebral venous and sinus thrombosis by high resolution magnetic resonance vessel wall imaging,to explore the diagnostic efficiency and application value of HRMR-VWI in the recognition and staging of CVST.Methods:Prospectively enrolled 42 patients with clinically suspected CVST in the First Affiliated Hospital of Xinjiang Medical University from February 2019 to October 2020.Digital subtraction angiography(DSA)was used as the gold standard to evaluate the accuracy of MRV and HRMR-VWI in segmental diagnosis of cerebral venous and sinus thrombosis.According to the time from the onset of clinical symptoms to the examination,the patients were divided into acute group(≤ 14 days,22 cases)and chronic group(> 15 days,20 cases),The signal-to-noise ratio(SNR)of thrombus on HRMR-VWI images 、 the contrast-to-noise ratio(CNR)between thrombus and normal lumen and the contrast-to-noise ratio(CNR)between thrombus and brain parenchyma were measured to compare the thrombus signal difference between the two groups.Results:Among 42 patients with CVST,DSA diagnosed 128 veins and venous sinuses with thrombosis,MRV accurately identified 120 places,the sensitivity was 93.8%,the specificity was 97.2%,and the positive predictive value was 90.2%.The negative predictive value is 98.2%;HRMR-VWI accurately identifies 122 locations,the sensitivity is 95.3%,the specificity is 98.3%,the positive predictive value is 93.8%,and the negative predictive value is 98.7%;The Kappa values of the consistency coefficients of MRV and HRMR-VWI at the vessel segment level and the reference diagnosis were 0.8966 and 0.9305,respectively.The SNR of thrombus in the acute group and the chronic group were 210.34±45.47 and96.11±30.05,respectively.The CNR between the thrombus and the lumen were 206.18±44.33 and 91.35±30.21,respectively.The CNR between the thrombus and brain parenchyma were 109.28±33.72 and 9.12±7.32,respectively.The difference between the two groups was statistically significant(P< 0.05).Conclusion:High-resolution magnetic resonance vessel wall imaging is a reliable direct thrombus imaging technique for diagnosing cerebral venous and sinus thrombosis.It can clearly identify thrombus and evaluate staging.