Current DVT imaging

Katz, Douglas S.; Hon, Man

doi:10.1053/j.tvir.2004.02.002

Cited by 38 publications

(18 citation statements)

References 33 publications

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“…Physical examination is insufficient to diagnose MTS, and the accuracy of Doppler ultrasound in imaging venous spurs among patients with suspected MTS is not convincing; it is technically difficult to image venous compression and stenosis via ultrasound due to the deep location of the iliac veins . Given the widespread use of ultrasound to confirm the presence of an acute DVT, many iliofemoral DVT cases associated with MTS could potentially go undiagnosed. As such, a challenge of MTS, which has likely hampered attempts to quantify prevalence of this condition, is related to the necessity of invasive imaging for accurate diagnosis.…”

Section: Diagnosis Of May‐thurner Syndromementioning

confidence: 99%

May‐Thurner syndrome: History of understanding and need for defining population prevalence

Harbin

Lutsey

2020

Journal of Thrombosis and Haemostasis

100

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Patients with May‐Thurner syndrome (MTS) are at elevated risk of developing an extensive left iliofemoral deep vein thrombosis (DVT; localized blood clot) due to an anatomical variant where the right common iliac artery compresses the left common iliac vein against the lumbar spine. While MTS was initially presumed to be rare when it was first anatomically defined in 1957, case reports of this syndrome have recently become more frequent, perhaps due to improved imaging techniques allowing for enhanced visualization of the iliac veins. Still, the population burden of this condition is unknown, and there is speculation it may be higher than generally perceived. In the present review, we (a) review history of how MTS became recognized, (b) describe practical challenges of studying MTS in population‐based settings due to the specialized imaging required for diagnosis, (c) discuss why the contribution of MTS to DVT may be underestimated, (d) describe uncertainty regarding the degree of venous compression which leads to DVT, and (e) outline future research needs. Our goal is to raise awareness of MTS and spark additional research into the epidemiology of this condition, which may be an underappreciated causative venous thromboembolism risk factor.

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Section: Diagnosis Of May‐thurner Syndromementioning

confidence: 99%

May‐Thurner syndrome: History of understanding and need for defining population prevalence

Harbin

Lutsey

2020

Journal of Thrombosis and Haemostasis

100

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“…In this study, contrast‐enhanced non‐Dixon T 1 ‐weighted spoiled gradient echo (SGRE) MRI acquired in either the arterial and venous phase or in the venous phase only. This is widely regarded as the reference standard for IVC clot . Therefore, we recommend that in addition to water and fat images, single‐echo postcontrast T 1 sequences should be reviewed when a potential thrombus‐mimicking artifact is detected.…”

Section: Discussionmentioning

confidence: 99%

Thrombus-mimicking artifacts in two-point Dixon MRI: Prevalence, appearance, and severity

Schubert

Bannas

Kinner

et al. 2016

J. Magn. Reson. Imaging

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Purpose To evaluate the incidence and severity of potentially thrombus mimicking, flow-induced misallocation artifacts in a clinical setting. Two-point “Dixon” fat–water separation methods, with bipolar readout gradients, may suffer from flow-induced fat–water misallocation artifacts. If these artifacts occur within blood vessels, they may mimic thrombus. Materials and Methods Two-point Dixon coronal and axial images acquired in 102 consecutive patients were retrospectively evaluated for the presence of flow-induced artifacts in arteries and veins. Artifacts were graded on a 3-point scale (none, mild, severe) by two independent readers. Interreader agreement was evaluated with kappa statistics. Results Reader 1 reported 63 artifacts in 46 (45%) of the cases (severe in 19 cases, 18.6%). Reader 2 reported 51 artifacts in 43 (42.2%) of the cases (severe in 18 cases, 17.6%). Misallocation of fat and water was apparent in all datasets with severe artifacts, whereas variable signal intensity changes in water and fat images were observed in mild artifacts. Interreader agreement was good for artifacts appearing in coronal images (κ = 0.7) and fair for artifact appearance in axial images (κ = 0.24). Conclusion Our study shows a high incidence of flow-induced mild and severe artifacts in a two-point Dixon method with bipolar readout gradients. This artifact should not be misinterpreted as intravascular thrombus.

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“…CDDUS is the initial test of choice for diagnosis of acute DVT due to its high accuracy, relatively low cost, portability, widespread, and lack of ionizing radiation [16]. B-mode ultrasound with Doppler color and duplex is the only noninvasive imaging test that combines anatomy and physiology of the veins by visualization of vein morphology and the map of flow velocity and direction.…”

Section: Color Doppler Duplex Ultrasonographymentioning

confidence: 99%

Multimodality Imaging of the Peripheral Venous System

Gaitini

2006

International Journal of Biomedical Imaging

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The purpose of this article is to review the spectrum of image-based diagnostic tools used in the investigation of suspected deep vein thrombosis (DVT). Summary of the experience gained by the author as well as relevant publications, regarding vein imaging modalities taken from a computerized database, was reviewed. The imaging modalities reviewed include phlebography, color Doppler duplex ultrasonography (CDDUS), computerized tomography angiography (CTA) and venography (CTV), magnetic resonance venography (MRV), and radionuclide venography (RNV). CDDUS is recommended as the modality of choice for the diagnosis of DVT. A strategy combining clinical score and D-dimer test refines the selection of patients. Phlebography is reserved for discrepant noninvasive studies.

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Current DVT imaging

Cited by 38 publications

References 33 publications

May‐Thurner syndrome: History of understanding and need for defining population prevalence

May‐Thurner syndrome: History of understanding and need for defining population prevalence

Thrombus-mimicking artifacts in two-point Dixon MRI: Prevalence, appearance, and severity

Multimodality Imaging of the Peripheral Venous System

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