Role of computed tomography perfusion in acute diagnosis of patients with cerebral venous thrombosis

The diagnostic yield of CTP for cerebral venous thrombosis (CVT) is uncertain. We aimed to estimate the sensitivity, specificity, predictive values and area under the curve (AUC) of CTP for CVT diagnosis, hypothesizing that CTP review would increase CVT diagnosis accuracy. Retrospective analysis of patients with stroke-like symptoms undergoing brain NCCT, CTA and CTP at a single centre. Patients with a final diagnosis of CVT (8) were analyzed together with a control group (40, 5:1 ratio) by three neurologists blinded to diagnosis. Brain NCCT+/-CTA showed poor sensitivity (37.5%) with high specificity (100%) for CVT diagnosis, which increased to 50% and 100% respectively after additional review of all the CTP maps. The discrimination of brain NCCT+/-CTA for CVT was moderate, AUC of 68.8 (95% CI: 50.8-86.7), increasing to AUC of 75 (95% CI: 56.5-93.5) after adding all the CTP maps reviews.