Deep vein thrombosis MRI

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Editors-in-Chief: C. Michael Gibson, M.S., M.D. Associate Editor-In-Chief: Ujjwal Rastogi, MBBS [1]; Kashish Goel, M.D.

Overview

MRI can also be used for the diagnosis of venous thrombosis, however is usually not applied as a first test because of cost and inaccessibility. MRI can be used in multiple ways:

Without contrast: Phase -contrast venography or time-of-flight).
Use of IV gadolinium contrast.
Direct thrombus imaging (visualizing thrombus against a suppressed background).

In a double blinded study, involving 85 patients suspected of having DVT, magnetic resonance venography (MRV) had a 100% sensitivity and 96% specificity, as compared with contrast venography.^[1] In this study, DVT was documented by contrast venography in 27 (27%) venous systems. Results of MRV and contrast venography were identical in 98 (97%) of 101 venous systems, whereas results of duplex scanning and contrast venography were identical in 40 (98%) of 41 venous systems. All DVTs identified by contrast venography were detected by MRV and duplex scanning. Thus it was concluded that MRV is an accurate noninvasive venographic technique for the detection of DVT.

Use

MRI has an important role in diagnosis when contrast venography cannot be performed due to patients allergy to iodinated contrast or in acute renal insufficiency.
MRI may also be used performed to diagnose DVT if compression ultrasound is not feasible because of the presence of a cast or excessive swelling.