Unenhanced CT density of cerebral venous sinus in acute cerebral venous sinus thrombosis

Objective: To assess the value of unenhanced CT densities of cerebral venous sinuses (CVS) for diagnosing acute CVS thrombosis. Methods: Unenhanced CT densities of CVS of 28 patients with acute CVS thrombosis were compared with that of 28 patients with normal hemoglobin and hematocrit levels, and 28 patients with elevated hemoglobin and hematocrit levels. Results: The maximum CT densities of patients with CVS thrombosis (62-86 HU, average: 76.21 ± 5.90 HU) were significantly (t = 9.740, P < 0.001; t = 24.400, P < 0.001) higher than that of patients without (37-56 HU, average: 44.14 ± 3.99 HU) and with (5169 HU, average: 62.61 ± 4.71 HU) elevated hemoglobin and hematocrit levels. The analysis of receiver operating characteristics curve showed area under the curve of 0.966 at CT density of 68.50 HU with 92.9% sensitivity and 96.4% specificity for diagnosing acute CVS thrombosis. Conclusion: CT density greater than 68.50 HU warrants further imaging to confirm CVS thrombosis. (authors)