Superior sagittal sinus thrombosis: assessment with Tc-99m labeled red blood cells

The diagnostic value of scintigraphy with technetium-99m labeled red blood cells (Tc-RBC) was assessed in 19 patients with clinical suggestion of superior sagittal sinus thrombosis (SSST). Comparison of Tc-RBC static images with dynamic flow studies in the brain showed a sensitivity of 100%, specificity of 86%, and accuracy of 94% for static studies and values of 87%, 20%, and 61%, respectively, for the flow studies. Tc-RBC scintigraphy enables direct visualization of the integrity of the superior sagittal sinus, whereas CT scanning shows various but nonspecific changes in the brain associated with SSST. Single-photon emission CT study using Tc-RBC, performed in six patients, appears to have potential in the diagnosis of SSST, allowing separation of vascular structures that are superimposed on the superior sagittal sinus in planar scintigraphy study.