Utility of Balanced Steady-State Free Precession MR Venography in the Diagnosis of Lower Extremity Deep Venous Thrombosis

Abstract

Balanced steady-state free precession MR venography is highly accurate in the diagnosis of lower extremity deep venous thrombosis.

Advanced imaging in acute and chronic deep vein thrombosis

“…Lindquist et al found that in comparison with US, balanced-SSFP MRV had a sensitivity of 94.7% and specificity of 100% (62). As A B C compared to US, the scanning time is less (20 vs. 7-10 min for the SSFP-MRV) and can be useful in patients with painful swollen legs in whom US is exceedingly painful and technically challenging.…”

Use of blood pool agents with steady‐state MRI to assess the vascular system

“…Traditional MR venography has been of limited use due to cost and perceived long acquisition times during time‐of‐flight (TOF) sequences . However, advances in blood pool agent with SSMRV have overcome many of these issues by producing images with high SNRs in shorter acquisition times (ie, 7‐10 minutes) .…”

“…Traditional MR venography has been of limited use due to cost and perceived long acquisition times during time‐of‐flight (TOF) sequences . However, advances in blood pool agent with SSMRV have overcome many of these issues by producing images with high SNRs in shorter acquisition times (ie, 7‐10 minutes) . SSMRV has been shown to have excellent sensitivity and specificity in detecting acute DVT in the iliac, femoral, popliteal, and calf muscle veins, but is less reliable in the tibial and peroneal veins compared to contrast venography .…”

Practical applications of balanced steady-state free-precession (bSSFP) imaging in the abdomen and pelvis

“…Compared to single‐shot half‐Fourier FSE/TSE (HASTE or ssFSE), which is more commonly used in abdominal/pelvic MRI, bSSFP provides several additional advantages including: 1) higher resolution images due to less imaging blur related to the extended echo train of ssFSE, and 2) lower SAR, which may be particularly advantageous when imaging at 3T or in patients with SAR restrictions (eg, restricted medical devices, pregnancy, and pediatrics) . Potential disadvantages of bSSFP compared to single‐shot FSE include: a) susceptibility artifacts encountered with GRE compared to FSE; b) T 2 / T 1 weighting compared to T 2 ‐weighted imaging, which may limit characterization of tissues when basing assessment on a structures T 2 signal (for example, when assessing the T 2 signal of a hepatic or renal mass); c) etching (india ink), banding, and fringe artifacts, which may compromise image quality (discussed below).…”