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Acute Abdominal Venous Thromboses—The Hyperdense CT Sign

Goldstein, Mark MB ChB, FRCR*†; Quen, Lye Hon MBBS, FRCR*‡; Jacks, Lindsay MSc, A.Stat; Jhaveri, Kartik MD*

Journal of Computer Assisted Tomography: January/February 2012 - Volume 36 - Issue 1 - p 8–13
doi: 10.1097/RCT.0b013e3182436c86
Abdominal Imaging

Objective To assess the ability of unenhanced computed tomography (CT) for diagnosis of acute abdominal venous thrombosis (VT).

Method This retrospective study matched 29 patients with 52 VT with a control group of 29 patients without VT. Two radiologists independently evaluated the unenhanced CT on standard abdominal and narrowed window settings to detect acute VT by anatomical location and confidence level. The effect of age, sex, hemoglobin, and hematocrit on VT density (HU) was also evaluated.

Results Overall sensitivity, specificity, and accuracy were 77.9% (95% CI, 66%–85%), 96.7% (95% CI, 94%–98%), and 95.4% (95% CI, 93%–96%), respectively, in the detection of VT, with improved sensitivity and confidence ratings on narrowed windows. Mean VT density (Hounsfield unit) was positively associated with hemoglobin and hematocrit and significantly higher than background blood (67.2 vs 37.0; P < 0.0001).

Conclusion Acute abdominal VT can be detected on unenhanced CT in more than two thirds of the cases by identifying hyperdense venous segments.

From the *Joint Department of Medical Imaging, University Health Network and Mount Sinai Hospital, Toronto General Hospital, Toronto, Ontario, Canada; †John Radcliffe Hospital, Headington, Oxford, UK; ‡University Hospital, Coventry, Coventry, UK; and §Princess Margaret Hospital, Toronto, Ontario Canada.

Received for publication October 4, 2011; accepted November 22, 2011.

Reprints: Mark Goldstein, MB ChB, FRCR, Joint Department of Medical Imaging, University Health Network and Mount Sinai Hospital, Toronto General Hospital, 200 Elizabeth St, Toronto, Ontario M5G 2C4, Canada (e-mail: goldsteinmark@yahoo.co.uk).

The authors report no conflicts of interest.

© 2012 Lippincott Williams & Wilkins, Inc.