Idiopathic intracranial hypertension: the prevalence and morphology of sinovenous stenosis.
OBJECTIVE
To determine the prevalence and nature of sinovenous obstruction in idiopathic intracranial hypertension (IIH) using auto-triggered elliptic-centric-ordered three-dimensional gadolinium-enhanced MR venography (ATECO MRV).


METHODS
In a prospective controlled study, 29 patients with established IIH as well as 59 control patients underwent ATECO MRV. In a randomized blinded fashion, three readers evaluated the images. Using a novel scoring system, each reader graded the degree of stenosis seen in the transverse and sigmoid sinuses of each patient.


RESULTS
There was excellent agreement across the three readers for application of the grading system. Substantial bilateral sinovenous stenoses were seen in 27 of 29 patients with IIH and in only 4 of 59 control patients.


CONCLUSIONS
Using ATECO MRV and a novel grading system for quantifying sinovenous stenoses, the authors can identify IIH patients with sensitivity and specificity of 93%.
Department of Medical Imaging, Toronto Western Hospital, ON, Canada. richard.farb@utoronto.ca
R I
RI
Farb
I
I
Vanek
J N
JN
Scott
D J
DJ
Mikulis
R A
RA
Willinsky
G
G
Tomlinson
K G
KG
terBrugge
D000328:Adult; D000368:Aged; D002426:Cavernous Sinus / Q000000981:diagnostic imaging / Q000473:pathology*; D002550:Cerebral Veins / Q000000981:diagnostic imaging / Q000473:pathology*; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D019586:Intracranial Hypertension / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011859:Radiography; D016037:Single-Blind Method