Role of CT Perfusion in Acute Diagnosis of Patients with Cerebral Venous Thrombosis

The diagnostic yield of CTP for cerebral venous thrombosis (CVT) is uncertain. We aimed to estimate the sensitivity, specificity, predictive values, and area under the curve (AUC) of CTP for CVT diagnosis, hypothesizing that CTP review would increase CVT diagnosis accuracy. This is a retrospective analysis of patients with stroke-like symptoms undergoing brain NCCT, CTA, and CTP at a single center. Patients with a final diagnosis of CVT (8) were analyzed together with a control group (40, 5:1 ratio) by 3 neurologists blinded to the diagnoses. Brain NCCT+/-CTA showed poor sensitivity (37.5%) with high specificity (100%) for CVT diagnosis, which increased to 50% and 100%, respectively, after additional review of all the CTP maps. The discrimination of brain NCCT+/-CTA for CVT was moderate (AUC = 68.8; 95% CI, 50.8-86.7), increasing to AUC = 75 (95% CI, 56.5-93.5) after adding all the CTP maps reviews.