Accuracy of magnetic resonance venography in diagnosing cerebral venous sinus thrombosis

• Published in: Thrombosis research 2018-07, Vol.167, p.64-73
• Main Authors: Gao, Liansheng, Xu, Weilin, Li, Tao, Yu, Xiaobo, Cao, Shenglong, Xu, Hangzhe, Yan, Feng, Chen, Gao
• Format: Article
• Language: English
• Subjects: Cerebral venous sinus thrombosis; Cerebral venous thrombosis; Digital subtraction angiography; Magnetic resonance venography; Meta-analysis
• ISSN: 0049-3848; 1879-2472
• DOI: 10.1016/j.thromres.2018.05.012

The non-specific clinical manifestations and lack of effective diagnostic techniques have made cerebral venous sinus thrombosis (CVST) difficult to recognize and easy to misdiagnose. Several studies have suggested that different types of magnetic resonance venography (MRV) have advantages in diagnosing CVST. We conducted this meta-analysis to assess the accuracy of MRV in identifying CVST. We searched the Embase, PubMed, and Chinese Biomedical (CBM) databases comprehensively to retrieve eligible articles up to Mar 31, 2018. The methodological quality of each article was evaluated individually. The summary diagnostic accuracy of MRV for CVST was obtained from pooled analysis with random-effects models. Sensitivity analysis, subgroup analysis, and meta-regression were used to explore the sources of heterogeneity. A trim and fill analysis was conducted to correct the funnel plot asymmetry. The meta-analysis synthesized 12 articles containing 27 cohorts with a total of 1933 cases. The pooled sensitivity and specificity were 0.86 (95% CI: 0.83, 0.89) and 0.94 (95% CI: 0.93, 0.95), respectively. The pooled diagnostic odds ratio (DOR) was 75.24 (95% CI: 38.33, 147.72). The area under the curve (AUC) was 0.9472 (95% CI: 0.9229, 0.9715). Subgroup analysis and meta-regression analysis revealed the technical types of MRV and the methods of counting cases contributing to the heterogeneity. The trim and fill method confirmed that publication bias has little effect on our results. MRV has excellent diagnostic performance and is accurate in confirming CVST. •CVST is a rare but lethal cerebrovascular disease. Early diagnosis and proper treatment could remarkably improve prognosis.•MRV has excellent diagnostic performance and is effective in confirming CVST.•The elliptic centric MRV has high spatial resolution and definition for clinical use.