Deep vein thrombosis MRI
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Editor(s)-In-Chief: The APEX Trial Investigators, C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2] ; Kashish Goel, M.D.; Assistant Editor(s)-In-Chief: Justine Cadet
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Overview
MRI can also be used for the diagnosis of venous thrombosis, however it is usually not applied as a first test because of cost and inaccessibility.
MRI
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 a patient being allergic to iodinated contrast or if the patient is in acute renal insufficiency.
- MRI may also be performed to diagnose DVT if compression ultrasound is not feasible because of the presence of a cast or excessive swelling.
Examples
- 2D TOF GRE MRV images: Bilateral deep vein thromboses
References
- ↑ Carpenter JP, Holland GA, Baum RA, Owen RS, Carpenter JT, Cope C (1993). "Magnetic resonance venography for the detection of deep venous thrombosis: comparison with contrast venography and duplex Doppler ultrasonography". J Vasc Surg. 18 (5): 734–41. PMID 8230557.