title: A new index for the assessment of transverse sinus stenosis for diagnosing idiopathic intracranial hypertension.
abstract: OBJECTIVE
  To assess the role of MR venography (MRV) for detecting transverse sinus stenosis, to determine the importance of this finding in idiopathic intracranial hypertension (IIH), and to propose an index that contributes to this diagnosis.
  
  
  METHODS
  We retrospectively assessed consecutive intracranial MRV of patients aged >18 years diagnosed with IIH according to the diagnostic criteria, between January 2010 and July 2012. The assessments were randomly analyzed by three radiologists. Stenoses in the right and left transverse sinuses were independently classified according to the following scale: 0, normal; 1, stenosis <33%; 2, stenosis 33-66%; 3, stenosis >66%; and 4, hypoplasia or agenesis. We established an index based on multiplication of the stenosis scale values for each transverse sinus. A point and range estimate of the sensitivity, specificity, and the area under the receiver operating characteristic curve was performed to obtain cut-off points to differentiate between controls and patients.
  
  
  RESULTS
  63 individuals were included in this study: 32 (50.8%) diagnosed with IIH (31 (96.9%) women and 1 (3.1%) man) and 31 (49.2%) controls. According to all of the examiners, the IIH group showed a higher degree of stenosis than the control group. Index values ≥4 for a diagnosis of IIH had a sensitivity and specificity of 94.7% and 93.5%, respectively.
  
  
  CONCLUSIONS
  MRV should be used to assess patients with suspected IIH, and bilateral transverse sinus stenosis should be considered for the diagnosis. The stenosis classifying index proposed here is a fast and accessible method for diagnosing IIH.
authors.affiliation: Department of Diagnostic Imaging, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Gustavo Balthazar da Silveira
authors.identifier: http://orcid.org/0000-0002-1434-4571
authors.initials: GB
authors.lastname: Carvalho
authors.affiliation: Department of Neurology, Universidade Federal De São Paulo, São Paulo, Brazil.
authors.forename: Sandro Luiz de Andrade
authors.identifier: http://orcid.org/0000-0002-0479-2450
authors.initials: SL
authors.lastname: Matas
authors.affiliation: Department of Diagnostic Imaging, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Marcos Hideki
authors.identifier: http://orcid.org/0000-0001-9032-9712
authors.initials: MH
authors.lastname: Idagawa
authors.affiliation: Department of Diagnostic Imaging, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Luiz Antônio Tobaru
authors.identifier: http://orcid.org/0000-0002-6323-2250
authors.initials: LA
authors.lastname: Tibana
authors.affiliation: Department of Diagnostic Imaging, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Renato Sartori
authors.identifier: http://orcid.org/0000-0002-0084-5754
authors.initials: RS
authors.lastname: de Carvalho
authors.affiliation: Department of Diagnostic Imaging, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Matheus Luis Souza
authors.identifier: http://orcid.org/0000-0001-8203-6960
authors.initials: ML
authors.lastname: Silva
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Hugo
authors.identifier: http://orcid.org/0000-0001-9411-9237
authors.initials: H
authors.lastname: Cogo-Moreira
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Andrea Parolin
authors.identifier: http://orcid.org/0000-0001-8842-5406
authors.initials: AP
authors.lastname: Jackowski
authors.affiliation: Department of Diagnostic Imaging, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Nitamar
authors.initials: N
authors.lastname: Abdala
mesh_terms: D000328:Adult; D019540:Area Under Curve; D002533:Cerebral Angiography; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D019586:Intracranial Hypertension / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D012189:Retrospective Studies; D054064:Transverse Sinuses / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: Intracranial Pressure; MRI