TY - JOUR
T1 - Quantitative evaluation of noncontrast computed tomography of the head for assessment of anemia
AU - Chaudhry, Ammar A.
AU - Gul, Maryam
AU - Chaudhry, Abbas
AU - Sheikh, Mubashir
AU - Dunkin, Jared
N1 - Publisher Copyright:
© 2015 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2015
Y1 - 2015
N2 - Background and Purpose: Anemia is an underdiagnosed clinical entity with significant mortality and morbidity. We aimed to assess whether attenuation of dural venous sinuses correlateswith hemoglobin/hematocrit and to determine if the degree of anemia can be predicted by quantitative analysis of unenhanced computed tomography (CT) of the head. Materials and Methods: This is an institutional review board- approved retrospective study including 500 patients who underwent emergency department investigation for potential central nervous system etiology of their symptoms with unenhanced CT head at a tertiary care center. Computed tomographic attenuation values were obtained by 2 independent readers, whereas 2 separate investigators collected clinical data. Regression analyses were performed to evaluate the strength of correlation and the predictability of anemia and its severity on unenhanced CT. Receiver operating characteristic curve analyses were performed to evaluate sensitivity, specificity, as well as positive and negative predictive values. Results: A total of 243 met the inclusion criteria, and attenuation values for all the dural venous sinuses were averaged and categorized according to hemoglobin values of less than 8, 8 to 10, 10 to 14, and greater than 14. Mean CT attenuation values for both readers were 36.30, 42.35, 47.99, and 53.25 Hounsfield units. Regression analysis revealed the highest positive correlation of hemoglobin/hematocrit with attenuation at the confluence of sinuses with R2 value of 0.63 and 0.60. The sensitivity, specificity, and negative predictive value of detecting hemoglobin of less than 10 at confluence of sinuses were 91.2%, 88.5%, and 98.6%, respectively. Interobserver agreement was found to be good (0.64) using the κ statistic. Conclusions: Our study substantiates direct positive correlation between CT attenuation of dural venous sinuses and hemoglobin/hematocrit, with strongest correlation at the confluence of sinuses with good sensitivity, specificity, and negative predictive value.
AB - Background and Purpose: Anemia is an underdiagnosed clinical entity with significant mortality and morbidity. We aimed to assess whether attenuation of dural venous sinuses correlateswith hemoglobin/hematocrit and to determine if the degree of anemia can be predicted by quantitative analysis of unenhanced computed tomography (CT) of the head. Materials and Methods: This is an institutional review board- approved retrospective study including 500 patients who underwent emergency department investigation for potential central nervous system etiology of their symptoms with unenhanced CT head at a tertiary care center. Computed tomographic attenuation values were obtained by 2 independent readers, whereas 2 separate investigators collected clinical data. Regression analyses were performed to evaluate the strength of correlation and the predictability of anemia and its severity on unenhanced CT. Receiver operating characteristic curve analyses were performed to evaluate sensitivity, specificity, as well as positive and negative predictive values. Results: A total of 243 met the inclusion criteria, and attenuation values for all the dural venous sinuses were averaged and categorized according to hemoglobin values of less than 8, 8 to 10, 10 to 14, and greater than 14. Mean CT attenuation values for both readers were 36.30, 42.35, 47.99, and 53.25 Hounsfield units. Regression analysis revealed the highest positive correlation of hemoglobin/hematocrit with attenuation at the confluence of sinuses with R2 value of 0.63 and 0.60. The sensitivity, specificity, and negative predictive value of detecting hemoglobin of less than 10 at confluence of sinuses were 91.2%, 88.5%, and 98.6%, respectively. Interobserver agreement was found to be good (0.64) using the κ statistic. Conclusions: Our study substantiates direct positive correlation between CT attenuation of dural venous sinuses and hemoglobin/hematocrit, with strongest correlation at the confluence of sinuses with good sensitivity, specificity, and negative predictive value.
KW - Anemia
KW - Computed tomography
KW - Dural venous sinus
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U2 - 10.1097/RCT.0000000000000306
DO - 10.1097/RCT.0000000000000306
M3 - Review article
C2 - 26359582
AN - SCOPUS:84947611356
SN - 0363-8715
VL - 39
SP - 842
EP - 848
JO - Journal of computer assisted tomography
JF - Journal of computer assisted tomography
IS - 6
ER -