Noncontrast CT in Deep Cerebral Venous Thrombosis and Sinus Thrombosis: Comparison of its Diagnostic Value for Both Entities

Examples for true-positive, false-positive, and false-negative cord signs in the evaluation of sinus thrombosis. A, A 35-year-old woman with an SVT of the SSS and the RTS, who presented with headache and nausea. The NCCT scan shows a true-positive cord sign in the SSS (dotted arrow) and the RTS (arrows). The case of this patient was judged as positive with regard to the presence of a cord sign by all 3 readers. B, A 27-year-old woman in the control group, who initially presented with headache, but all other available imaging modalities showed no pathologic findings and clinical follow-up was uneventful. The RTS appeared hyperattenuated on NCCT (arrows). This finding was interpreted as a cord sign by all readers, resulting in the false-positive diagnosis of a SVT in this patient. C and D, A 45-year old woman with headache and nausea and a SVT involving the RTS and the SSS. The NCCT scan (C) shows no hyperattenuated signal intensity (ie, no cord sign) in the RTS or the SSS: The case of this patient was judged as false-negative regarding the presence of a cord sign by all readers. D, Multiplanar sagittal reconstruction of a MDCTA demonstrates contrast-filling defects in the RTS (arrow) and in the SSS (dotted arrow), indicating an SVT.