Abdominopelvic and lower extremity deep venous thrombosis: Evaluation with contrast-enhanced mr venography with a blood-pool agent

Steven Y. Huang, Charles Y. Kim, Michael J. Miller, Rajan T. Gupta, Mark L. Lessne, Jeffrey J. Horvath, Daniel T. Boll, Paul D. Evans, Nicholas T. Befera, Pranay Krishnan, Johanna L. Chan, Elmar M. Merkle

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE. The purpose of this article is to evaluate contrast-enhanced (CE) MR venography (MRV) with a blood-pool agent for detection of abdominopelvic and lower extremity deep venous thrombosis (DVT) compared with a conventional unenhanced gradientrecalled echo (GRE) MRV technique. MATERIALS AND METHODS. This retrospective study was performed on 30 patients (mean age, 52.7 years; 15 men and 15 women) referred for MRV between March 2010 and November 2010 for evaluation of lower extremity or abdominopelvic DVT. All patients underwent a GRE sequence followed by a CE T1-weighted sequence with gadofosveset, a blood-pool agent. The abdominopelvic and lower extremity venous system was divided into 13 segments. The presence of acute or chronic DVT was assessed by six radiologists, as well as qualitative and quantitative assessments of each venous segment. Image acquisition and interpretation times were also tabulated. RESULTS. The sensitivity and specificity for acute DVT were 91.0% and 99.8%, respectively, on CE MRV compared with 80.8% and 95.8%, respectively, on GRE MRV (p = 0.077 and p < 0.001). The sensitivity and specificity for chronic DVT were 84.4% and 98.4%, respectively, on CE MRV and 64.5% and 95.6%, respectively, on GRE MRV (p < 0.001 for both). Subjective ratings of vein visualization, signal homogeneity, and confidence pertaining to DVT diagnosis were significantly higher with the CE images (p < 0.001). The contrast-tonoise ratio for CE images was similar or significantly higher for all venous segments. Image acquisition and radiologist interpretation times on the CE studies were decreased (p < 0.001). CONCLUSION. Gadofosveset-enhanced MRV had equal or higher sensitivity and specificity for detection of DVT than did GRE MRV, with decreased time for image acquisition and interpretation.

Original languageEnglish (US)
Pages (from-to)208-214
Number of pages7
JournalAmerican Journal of Roentgenology
Volume201
Issue number1
DOIs
StatePublished - Jul 1 2013

Keywords

  • Deep venous thrombosis
  • Gadofosveset
  • Lower extremities
  • MR venography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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