• Azin Shayganfar, Roya Azad, and Maryam Taki.
• Department of Radiology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
• J Res Med Sci. 2019 Jan 1; 24: 83.

BackgroundFor both the clinician and a radiologist, the diagnosis of cerebral venous sinus thrombosis (CVST), because of the variety of signs and symptoms, remains a challenge. In this study, the role of unenhanced brain computed tomography (CT) in the diagnosis of CVST was assessed.Materials And MethodsIn this case-control study, unenhanced CT of 35 patients with acute CVST was compared with 70 normal patients. Hematocrit (HCT), creatinine, and blood urea nitrogen were recorded in all patients. CT images were read, and the attenuation was measured by two independent experienced radiologists. The H:H ratio was calculated for all patients in both case and control groups to normalized densities regarding HCT.ResultsThe mean of attenuation in patients was 66.95 ± 10.63 Hounsfield unit (HU) and in the controls was 52.51 ± 2.92 HU (P < 0.0001). The mean of H:H ratio in patients was 1.78 ± 0.40 and in controls was 1.46 ± 0.28 (P < 0.0001). Attenuation >60.4 HU was the best optimal cutoff with area under the curve of 0.918 (0.848-0.962) and had 71.4% sensitivity and 100% specificity. H:H ratio >1.42 as the optimal cutoff had 94.3% sensitivity and 54.3% specificity for identifying the CVST.ConclusionAttenuation value >60.4 HU and H: H ratio >1.42 calculated based on unenhanced CT can be used as reliable methods to detect CVST in the absence of magnetic resonance imaging and magnetic resonance venography in the emergency setting.Copyright: © 2019 Journal of Research in Medical Sciences.

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