Fat‑suppressed magnetic resonance volume interpolated examination for deep venous thrombosis compared with duplex sonography

Abstract

The aim of the present study was to evaluate magnetic resonance venography (MRV) scanned by breath-hold volume interpolated body examination with spectral fat saturation (VIBE-fs), combined with Dixon fat-suppressed VIBE (VIBE-Dixon) by using a 1.5T MR scanner for detecting deep venous thrombosis (DVT) compared with duplex sonography. A total of 31 patients with DVT were identified using duplex sonography and were enrolled in the present study for MRV examination, from the inferior vena cava to the ankle level after injection of gadopentetate dimeglumine. Venous segment-to-segment comparison was assessed for DVT detection between MRV and duplex sonography. A total of two radiologists separately performed subjective image quality assessment using a 5-point scale. Cohen's κ coefficient, Wilcoxon rank sum test and intraclass correlation coefficient values were used for statistical analysis. Of the 303 evaluated vein segments, duplex sonography identified 119 (39.3%; 119/303) venous segments with thrombus, while MRV detected 170 (56.1%; 170/303) venous segments with thrombus. The diagnostic agreement rate of DVT between duplex sonography and MRV was poor in the deep femoral vein and anterior tibial veins, while it was excellent in the inferior vena cava (IVC), common iliac vein, external iliac vein, femoral vein, popliteal vein, posterior tibial veins and peroneal veins. In addition, poor reliability was detected in the deep femoral vein, anterior tibial veins and peroneal veins, but good to excellent reliability was observed in IVC, common iliac vein, external iliac vein, femoral vein, popliteal vein and posterior tibial veins. Furthermore, image quality scores of each venous segment between the two radiologists indicated no statistical difference. Therefore, MRV scanned using VIBE-fs for the suprainguinal and VIBE-Dixon for the infrainguinal region may be a useful method for detecting DVT compared with duplex sonography. The results of present study proved this MR protocol to be a beneficial alternative imaging modality for the detection of DVT when duplex sonography is inadequate or not able to be performed.

Diagnostic accuracy of true fast imaging with steady‑state precession, MR pulmonary angiography and volume‑interpolated body examination for pulmonary embolism compared with CT pulmonary angiography

“…Enhanced VIBE has been widely used for delineating vasculatures such as the pulmonary arteries (27) and the venous system of the lower legs (23,(27)(28)(29), as this sequence enables the vessel wall to be visualized and the intraluminal emboli to be outlined with the help of contrast material. With a high resolution and low slice thickness, on a per-patient basis and per-vessel basis in the present study, this sequence had an accuracy of 95.2 and 91.1%, respectively, a sensitivity of 94.4 and 68.1%, respectively, and a specificity of 100 and 99.2% respectively; the highest AUC in the ROC curve evaluation was obtained at the central, lobar and segmental levels, and a significant difference was detected, particularly at the segmental level, which proved VIBE to be the most accurate sequence for PE detection among the three sequences.…”