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Background <p>Diagnosing cerebral venous thrombosis (CVT) is challenging due to varied symptoms. Computed tomography venography (CTV) or magnetic resonance venography (MRV) are the gold standard, but resource-demanding with potential side effects. We evaluated the diagnostic properties of a previously proposed CVT probability score combined with D-dimer levels in detecting CVT.</p> Methods <p>Medical records of consecutive adults who underwent CTV or MRV due to suspicion of CVT at a Norwegian primary hospital were retrospectively analyzed. The CVT probability score was calculated based on previous medical history and clinical findings/symptoms at presentation to stratify patients into low, moderate or high CVT probability groups. Performance characteristics were calculated for the CVT probability score with and without D-dimer levels.</p> Results <p>Among 578 patients evaluated from 2016 to 2019, CVT was confirmed in 6.6%. The CVT probability score was available for 444 patients and distributed one-third of CVT patients across each CVT probability group, with a 0.33 sensitivity for each group. A negative predictive value (NPV) of 0.96 was noted for the high CVT probability group. The NPV was 0.99 for the combined low/moderate CVT probability group including D-dimer &gt; 500&#xa0;µg/L. The positive predictive values were all fairly low.</p> Conclusion <p>Our results indicate that using a CVT probability score and D-dimer levels can help exclude CVT; however, false positive cases present a clinical challenge and carry the risk of excessive advanced imaging.</p>

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Enhancing risk prediction for cerebral venous thrombosis: evaluation of an integrated approach with clinical CVT probability score and D-dimer levels

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月13日

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  • Iselin T. Syberg Dahl,
  • Sanpreet K. G. Dhami,
  • Diana Aguiar de Sousa,
  • Ola Nakken,
  • Svetozar Zarnovicky,
  • Kashif Waqar Faiz,
  • Else Charlotte Sandset,
  • Kjersti Grøtta Vetvik,
  • Espen Saxhaug Kristoffersen

摘要

Background

Diagnosing cerebral venous thrombosis (CVT) is challenging due to varied symptoms. Computed tomography venography (CTV) or magnetic resonance venography (MRV) are the gold standard, but resource-demanding with potential side effects. We evaluated the diagnostic properties of a previously proposed CVT probability score combined with D-dimer levels in detecting CVT.

Methods

Medical records of consecutive adults who underwent CTV or MRV due to suspicion of CVT at a Norwegian primary hospital were retrospectively analyzed. The CVT probability score was calculated based on previous medical history and clinical findings/symptoms at presentation to stratify patients into low, moderate or high CVT probability groups. Performance characteristics were calculated for the CVT probability score with and without D-dimer levels.

Results

Among 578 patients evaluated from 2016 to 2019, CVT was confirmed in 6.6%. The CVT probability score was available for 444 patients and distributed one-third of CVT patients across each CVT probability group, with a 0.33 sensitivity for each group. A negative predictive value (NPV) of 0.96 was noted for the high CVT probability group. The NPV was 0.99 for the combined low/moderate CVT probability group including D-dimer > 500 µg/L. The positive predictive values were all fairly low.

Conclusion

Our results indicate that using a CVT probability score and D-dimer levels can help exclude CVT; however, false positive cases present a clinical challenge and carry the risk of excessive advanced imaging.