The value of black-blood MRI in cerebral venous thrombosis diagnosis: A systematic review and meta-analysis

Abstract

Objective

To evaluate the diagnostic performance of black-blood MRI (BB-MRI) in detecting cerebral venous thrombosis (CVT).

Methods

This study was registered in PROSPERO [ID: CRD42024556451]. The PubMed/MEDLINE, Web of Science, Scopus, and Embase databases were searched for studies evaluating the performance of BB-MRI in diagnosing CVT. Studies were selected based on predefined eligibility criteria. The risk of bias was assessed using the QUADAS-2 tool. Meta-analysis was performed using a bivariate random-effects model to calculate pooled sensitivity, specificity, and area under the curve (AUC).

Results

Nine studies fulfilled the eligibility criteria and were included in the review; however, two studies insufficiently reported quantitative data. Thus, seven studies involving 176 CVT patients and 217 controls, encompassing 610 thrombosed and 3279 normal cerebral venous segments, were included in the meta-analysis. The studies demonstrated a high risk of bias in the patient selection and reference standard domains. The pooled sensitivity and specificity of BB-MRI were 96% [95% CI: 92%–98%] and 96% [95% CI: 93%–98%] on a patient-based level, and 92% [95% CI: 87%–95%] and 98% [95% CI: 92%–99%] on a venous-segment-based level, respectively. The AUC was 0.98 for patient-based data and 0.96 for venous-segment-based data.

Conclusions

BB-MRI demonstrates a significant potential as a diagnostic method for CVT. However, further comparative studies are needed to define its role in the diagnostic workup of patients suspected of having CVT.