Sensitivity and Specificity of Double-Track Sign in the Detection of Transverse Sinus Stenosis: A Multicenter Retrospective Study.
BACKGROUND
Transverse sinus stenosis (TSS) is common among patients with cerebral venous sinus thrombosis. No previous studies have reported on double-track sign detected on axial Gd-enhanced T1WI in TSS. This study aimed to determine the sensitivity and specificity of the double-track sign in the detection of TSS.


METHODS
We retrospectively reviewed medical records of 383 patients with transverse sinus thrombosis (TST) and 30 patients with normal transverse sinus from 5 participating hospitals in china from January 2008 to June 2014. 167 feasible transverse sinuses included in this study were categorized into TSS (n = 76), transverse sinus occlusion (TSO) (n = 52) and transverse sinus normal (TSN) groups (n = 39) according to imaging diagnosis on digital subtraction angiography (DSA) or magnetic resonance venography (MRV). Double-track sign on axial Gd-enhanced T1WI was compared among the three groups. Sensitivity and specificity of double-track sign in detection of TSS were calculated, with final imaging diagnosis of TSS on DSA or MRV as the reference standard.


RESULTS
Of 383 patients with TST recruited over a 6.5-year period, 128 patients were enrolled in the study, 255 patients were excluded because of insufficient clinical data, imaging finding and delay time, and 30 matched patients with normal transverse sinus were enrolled in the control group. Therefore, double-track sign assessment was conducted in 167 available transverse sinuses of 158 patients. Of the 76 sinuses in TSS group, 51 had double-track sign. Of the other 91 sinuses in TSO and TSN groups, 3 had a false-positive double-track sign. Thus, double-track sign on axial Gd-enhanced T1WI was 67.1% (95% CI 55.3-77.2) sensitive and 96.7% (95% CI 89.9-99.1) specific for detection of TSS.


CONCLUSIONS
The double-track sign on axial Gd-enhanced T1WI is highly specific and moderate sensitive for detection of TSS. Nevertheless, it could be a direct sign and might provide an early clue for TSS.
Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
De-Sheng
DS
Zhu
Department of Pathology, Fuzhou Medical College, Nanchang University, Fuzhou, China.
Jue
J
Fu
Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Yi
Y
Zhang
Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Chong
C
Xie
Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Xiao-Qing
XQ
Wang
Department of Neurology, Nanyuan Hospital, Beijing, China.
Yue
Y
Zhang
Department of Neurology, Dong Fang Hospital, School of medicine, Tong Ji University, Shanghai, China.
Jie
J
Yang
Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Shi-Xu
SX
Li
Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Xiao-Bei
XB
Liu
Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Zhi-Wen
ZW
Wan
Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
Qiang
Q
Dong
Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Yang-Tai
YT
Guan
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction / Q000379:methods; D016022:Case-Control Studies; D002533:Cerebral Angiography; D002681:China; D003251:Constriction, Pathologic / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012851:Sinus Thrombosis, Intracranial / Q000473:pathology; D054064:Transverse Sinuses / Q000473:pathology*; D055815:Young Adult