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Diagnostic performance of MR black-blood thrombus imaging for cerebral venous thrombosis in real-world clinical practice

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

An Editorial Comment to this article was published on 21 January 2022

Abstract

Objectives

MR black-blood thrombus imaging (BTI) has been developed for the detection of cerebral venous thrombosis (CVT). Yet, there is a lack of real-world data to verifying its clinical performance. This study aims to evaluate the performance of BTI in diagnosing and staging CVT in a 5-year period.

Methods

Patients suspected of CVT were enrolled between 2014 and 2019. Patients with or without BTI scans were classified into group A and group B, respectively. The prevalence of correct diagnosis of CVT and patients with evaluable clot age were compared. The diagnostic performance of BTI including sensitivity, specificity, and specific staging information was further analyzed.

Results

Two hundred and twenty-one of the 308 patients suspected of CVT were eligible in the current study (114 in group A and 97 in group B), with 125 diagnosed by multidisciplinary teams to have CVTs (56 in group A, 69 in group B). The rate of correct diagnosis of CVT was higher in group A than that in group B (94.7% vs 60.8%, p < 0.001, x2 = 36.517) after adding BTI images. The percent of patients with evaluable staged segments between the two groups were 96.4% and 33.9%, respectively (x2 = 48.191, p < 0.001). BTI showed a sensitivity of 96.4% and 87.9% in the detection of CVT on per-patient and per-segment level, respectively. Up to 98.1% of all thrombosed segments could be staged by BTI and 59.6% of them were matched with clinical staging.

Conclusions

In the actual clinical practice, BTI improves diagnostic confidence and has an excellent performance in confirming and staging CVT.

Key Points

• Black-blood thrombus imaging has good diagnostic performance in detecting cerebral venous thrombosis compared to traditional imaging methods with strong evidence in the actual clinical setting.

• BTI helps clinicians to diagnose CVT with more accuracy and confidence, which can be served as a promising imaging examination.

• BTI can also provide additional information of different thrombus ages objectively, the valuable reference for clinical strategy.

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Abbreviations

BTI:

Black-blood thrombus imaging

CVT:

Cerebral venous thrombosis

DANTE:

Delay alternating with nutation for tailored excitation

DCS:

Diagnostic confidence score

DSA:

Digital subtraction angiography

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Acknowledgements

We thank the patients involved in the study and appreciate the contribution of all investigators for our study.

Funding

This study has received funding from the Beijing Natural Science Foundation (7191003), the National Science Foundation of China (8191101305), the Beijing Municipal Administration of Hospitals’ Ascent Plan (DFL20180602), and the National Key Research and Development Program of China (2017YFC1308000). Zhaoyang Fan received salary support from the National Institutes of Health/National Heart, Lung, and Blood Institute (R01 HL147355).

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Authors and Affiliations

  1. Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, No. 8 Gongti Nanlu, Chaoyang District, Beijing, 100020, China

    Xiaoxu Yang, Yuehong Liu, Huibo Zhang & Qi Yang

  2. Department of Radiology, Xuanwu Hospital, Beijing, China

    Xiaoxu Yang & Fang Wu

  3. Department of Emergency, Xuanwu Hospital, Beijing, China

    Jiangang Duan

  4. Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Marc Fisher

  5. Department of Neurosurgery, Xuanwu Hospital, Beijing, China

    Xunming Ji

  6. Department of Neurology, Xuanwu Hospital, Beijing, China

    Ran Meng

  7. Radiology and Radiation Oncology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA

    Zhaoyang Fan

  8. Beijing Laboratory for Cardiovascular Precision Medicine, Beijing, China

    Qi Yang

  9. Key Laboratory of Medical Engineering for Cardiovascular Disease, Ministry of Education, Beijing, China

    Qi Yang

Authors
  1. Xiaoxu Yang
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  2. Fang Wu
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Correspondence to Zhaoyang Fan or Qi Yang.

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The scientific guarantor of this publication is Qi Yang.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

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Written informed consent was obtained from all subjects (patients) in this study.

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Institutional Review Board approval was obtained.

Methodology

• retrospective

• diagnostic study

• performed at one institution

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Yang, X., Wu, F., Liu, Y. et al. Diagnostic performance of MR black-blood thrombus imaging for cerebral venous thrombosis in real-world clinical practice. Eur Radiol 32, 2041–2049 (2022). https://doi.org/10.1007/s00330-021-08286-x

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  • DOI: https://doi.org/10.1007/s00330-021-08286-x

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