Evaluating the temporal changes of sinus density in patients with acute cerebral sinus vein thrombosis

Introduction: Despite the studies performed to characterize the clot’s features in the acute phase in non-contrast computed tomography (NCCT), no study has been conducted to evaluate the non-acute phase and the threshold density that warrants further evaluation. Herein, we assessed the temporal changes of sinus density in patients with acute CVST. Methods: : In this cross-sectional study, we searched our Picture Archiving and Communicating System (PACS) of our hospital between January 2015 and September 2021. Inclusion criteria were patients older than 18-year-old with acute CVST, with available Contrast-enhanced Magnetic Resonance Venography (CE-MRV) as the gold standard for confirming the presence and location of thrombosis. The readers were asked to assess the images regarding any subjective abnormal hyper- or hypo-attenuation within the venous sinus structures. Changes in the Hounsfield Unit (HU) of each venous segment during the time-course of the disease and the HU difference of affected sinus with other sinus segments were evaluated. Results: : Out of 89 CT scan evaluations, 21 cases (23.6%) were performed in the acute, 38 (42.7%) presented in the subacute, and 30 (33.7%) presented in the chronic stage. In all involved venous sinuses, the mean blood density of various phases was a statistically significant difference. The agreement of the two radiologists to report the hypodense sinus sign was reported to be 0.7.(p-value <0.001). Conclusions: : The results of our study suggest that quantitative measurement and qualitative findings of the hypodense sinus sign help to diagnose non-acute CVST better.