Document Detail


The venous distension sign: a diagnostic sign of intracranial hypotension at MR imaging of the brain.
MedLine Citation:
PMID:  17846197     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Patients with intracranial hypotension (IH) demonstrate intracranial venous enlargement with a characteristic change in contour of the transverse sinus seen on routine T1-weighted sagittal imaging. In IH, the inferior margin of the midportion of the dominant transverse sinus acquires a distended convex appearance; we have termed this the venous distension sign (VDS). This is distinct from the normal appearance of this segment, which usually has a slightly concave or straight lower margin. This sign is introduced, and its performance as a test for the presence of this disease is evaluated. MATERIALS AND METHODS: The transverse sinuses on T1-weighted sagittal imaging of 15 patients with IH and 15 control patients were independently assessed in a blinded fashion by 3 readers for the presence of a VDS. A present or absent VDS was determined for each patient by each reader, and a consensus result for each patient was determined by unanimity or majority rule. RESULTS: Using the VDS, the readers correctly identified 93% (14 of 15) of the IH patients and similarly 93% (14 of 15) of the control patients. There was a high rate of agreement among the readers for the interpretation of the VDS (multirater kappa = 0.82). The overall sensitivity of the VDS for the diagnosis of intracranial hypotension was 94%. Specificity was also 94%. CONCLUSION: The VDS appears to be an accurate test for the presence or absence of IH and may be helpful in the evaluation of these patients.
Authors:
R I Farb; R Forghani; S K Lee; D J Mikulis; R Agid
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  28     ISSN:  0195-6108     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-09-11     Completed Date:  2007-10-16     Revised Date:  2008-02-14    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1489-93     Citation Subset:  IM    
Affiliation:
Department of Medical Imaging, Division of Neuroradiology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada. richard.farb@utoronto.ca
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MeSH Terms
Descriptor/Qualifier:
Brain / pathology*
Cerebral Veins / pathology*
Female
Humans
Intracranial Hypotension / diagnosis*
Magnetic Resonance Imaging*
Male
Middle Aged
Retrospective Studies
Sensitivity and Specificity
Single-Blind Method

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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