The Validity of MRI and MRV in Diagnosis of Pseudotumor Cerebri | ||
| Iraqi Postgraduate Medical Journal | ||
| Volume 22, Issue 4, October 2023, Pages 386-392 PDF (219.64 K) | ||
| DOI: 10.52573/ipmj.2023.182261 | ||
| Authors | ||
| Mahmood Abdul Moneum Ahmed* 1; Hasan Azeez Al-Hamadani2; Noor Abbas Hummadi3 | ||
| 1Shar Teaching Hospital/Sulaymania, Iraq | ||
| 2Neuromedicine, College of Medicine, Al-Nahrain University, Baghdad, Iraq | ||
| 3Radiology, Al Nahrain College of Medicine. Baghdad, Iraq | ||
| Abstract | ||
| BACKGROUND: Pseudotumor cerebri (PTC) is an entity of uncertain cause recognized by increased intracranial pressure. The diagnosis rely on clinical symptoms, absence of structural, hydrocephalus, , vascular or intracranial mass lesion on imaging, increased cerebrospinal fluid pressure measured by lumbar puncture, and normal CSF composition. MRI (magnetic resonance image) and MRV (magnetic resonance venography) findings have been reported to be associated with Pseudotumor cerebri. OBJECTIVE: To assess the validity of individual magnetic resonance imaging (cross-sectional and venographic) signs associated with PTC and determine whether the gathering of cross sectional magnetic resonance image and magnetic resonance venography findings enhances the PTC diagnostic certainty. PATIENTS AND METHODS: It is a case-control study that 30 patients were included with PTC and 41 healthy persons. All participants (patients and controls) were subjected to brain MRI and MRV. MRI evaluated the presence or absence of the reported findings. Studies of MRV were evaluated the stenosis of transverse venous sinuses. RESULTS: Showed that partially empty sella had the best sensitivity (90%) with a specificity of 80.5%. Posterior displacement of stalk: had a sensitivity and specificity of 76.67% and 65.85%, respectively. Peri-optic nerve (PON) sheath distention revealed a sensitivity and specificity of 76.67% and 92.68%, respectively, making it one of the best MRI signs. These MRI signs when combined with MRV, the sensitivity and specificity of all signs increased largely. CONCLUSION: Three MRI signs; partially empty sella, posterior displacement of stalk, and PON sheath distention strongly suggest the diagnosis of PTC. Using MRV in combination with MRI findings greatly enhances the diagnostic value of all individual MRI findings in the detection of PTC. | ||
| Keywords | ||
| Pseudotumor cerebri; MRI and MRV. | ||
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