title: Prognostic indices for cerebral venous thrombosis on CT perfusion: a prospective study.
abstract: OBJECTIVE
  We determined the prognostic significance of CT perfusion characteristics of patients with cerebral venous sinus thrombosis (CVST) and assessed the change in perfusion parameters following anticoagulation therapy.
  
  
  METHODS
  20 patients with CVST diagnosed on non-contrast computed tomography (NCCT), magnetic resonance imaging (MRI), and magnetic resonance venography (MRV) were included in this study. The initial CT perfusion study was performed at the time of admission. The following perfusion parameters: relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), and relative mean transit time (rMTT) were calculated in the core and periphery of the affected area of the brain. Follow-up CT perfusion studies were performed at 1 month following anticoagulation therapy and the perfusion parameters thus obtained were compared with pre-treatment results. Receiver operating characteristic (ROC) curve analysis was performed to determine the prognostic significance of perfusion parameters.
  
  
  RESULTS
  All patients in this study showed areas of hypoperfusion on CT perfusion. To determine the favorable clinical outcome on basis of perfusion parameters, ROC curve analysis was performed which showed that the optimal threshold for rCBF>60.5%, rCBV>75.5%, and rMTT<148.5% correlated with better clinical outcomes. Post treatment perfusion parameters showed significant correlation in core of the lesion (p<0.05) than in the periphery.
  
  
  CONCLUSIONS
  CT perfusion studies in CVST are a good prognostic tool and yield valuable information regarding clinical outcome.
authors.affiliation: Department of Radiodiagnosis and Imaging, MMIMSR, Mullana, Ambala, India. Electronic address: rakrakgupta@gmail.com.
authors.forename: Rakesh Kumar
authors.initials: RK
authors.lastname: Gupta
authors.affiliation: Department of Radiology, Division of Neuroradiology, University Hospital, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI 48109, United States. Electronic address: jrajiv@med.umich.edu.
authors.forename: J R
authors.initials: JR
authors.lastname: Bapuraj
authors.affiliation: Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: N
authors.initials: N
authors.lastname: Khandelwal
authors.affiliation: Department of Neurology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Dheeraj
authors.initials: D
authors.lastname: Khurana
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D002533:Cerebral Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging / Q000379:methods*; D010690:Phlebography / Q000379:methods*; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012851:Sinus Thrombosis, Intracranial / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000925:Anticoagulants
keywords: Cerebral venous sinus thrombosis (CVST); Computed tomography (CT); Relative cerebral blood flow (rCBF); Relative cerebral blood volume (rCBV); Relative mean transit time (rMTT)