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From the Department of Medical Imaging (Drs. Farb, Scott, Mikulis, Willinsky, and terBrugge), Division of Neuroradiology, Division of Neuroophthalmology (Dr. Vanek), Toronto Western Hospital; and Department of Biostatistics (Dr. Tomlinson), University of Toronto, ON, Canada.
Address correspondence and reprint requests to Dr. Richard I. Farb, Division of Neuroradiology, Department of Medical Imaging, University Health Network, Toronto Western Hospital, Fell Pavilion 3-404, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada; e-mail: richard.farb{at}utoronto.ca
Objective: To determine the prevalence and nature of sinovenous obstruction in idiopathic intracranial hypertension (IIH) using auto-triggered elliptic-centric-ordered three-dimensional gadolinium-enhanced MR venography (ATECO MRV).
Methods: In a prospective controlled study, 29 patients with established IIH as well as 59 control patients underwent ATECO MRV. In a randomized blinded fashion, three readers evaluated the images. Using a novel scoring system, each reader graded the degree of stenosis seen in the transverse and sigmoid sinuses of each patient.
Results: There was excellent agreement across the three readers for application of the grading system. Substantial bilateral sinovenous stenoses were seen in 27 of 29 patients with IIH and in only 4 of 59 control patients.
Conclusion: Using ATECO MRV and a novel grading system for quantifying sinovenous stenoses, the authors can identify IIH patients with sensitivity and specificity of 93%.
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