Finding the origin of pulmonary emboli with a total-body magnetic resonance direct thrombus imaging technique

Langevelde, Kirsten van; Šrámek, A.; Vincken, Patrice W. J.; Rooden, Jan-Kees van; Rosendaal, Frits R.; Cannegieter, Suzanne C.

doi:10.3324/haematol.2012.069195

Cited by 97 publications

(78 citation statements)

References 57 publications

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“…First, studies have demonstrated that up to 50% of patients diagnosed with a PE will have no evidence of a DVT on ultrasonography. 20 When a diagnosis of a PE is made without diagnosing a DVT, there is typically no need to perform further testing to diagnose a DVT as it will not affect the treatment.…”

Section: Resultsmentioning

confidence: 99%

The Incidence and Mortality of Thromboembolic Events in Cervical Spine Surgery

Oglesby

Fineberg

Patel³

et al. 2013

Spine

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Thromboembolic events are potential complications of cervical spine surgery. The highest rates of VTE were identified in those patients undergoing posterior cervical fusion. Regardless of approach, DVT and PEs resulted in increased mortality rates and hospitalization. We recommend a thorough preoperative assessment to identify patients at risk for VTE and treat accordingly to decrease the incidence of these thromboembolic events.

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Section: Resultsmentioning

confidence: 99%

The Incidence and Mortality of Thromboembolic Events in Cervical Spine Surgery

Oglesby

Fineberg

Patel³

et al. 2013

Spine

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“…In approximately 50% of the cases, PE occurs secondary to embolization of thrombus material from a DVT 13. PEs can also originate from thrombi at the right side of the heart.…”

Section: Introductionmentioning

confidence: 99%

Acute infection as a trigger for incident venous thromboembolism: Results from a population‐based case‐crossover study

Grimnes

Isaksen

Tichelaar

et al. 2018

Research and Practice in Thrombosis and Haemostasis

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Essentials There is a bidirectional relation between acute infections and immobilizationWe studied the impact of infection and immobilization on risk of VTE in a case‐crossover designAcute infection was a strong trigger for VTE independent of concomitant immobilizationInfection and immobilization had a synergistic effect on the VTE‐risk BackgroundA bidirectional relation exists between acute infection and immobilization, and both are triggers for venous thromboembolism (VTE). To what extent the association between infection and VTE‐risk is explained by immobilization is unknown.AimsTo investigate the impact of hospitalization with acute infection on the VTE‐risk in patients with and without concomitant immobilization, and to explore the differential impact of respiratory‐ (RTI) and urinary‐ (UTI) tract infections on the risk of deep vein thrombosis (DVT) and pulmonary embolism (PE).MethodsWe conducted a case‐crossover study of VTE‐patients (n = 707) recruited from a general population. Hospitalizations and VTE‐triggers were registered during the 90 days before a VTE (hazard period) and in four preceding 90‐day control periods. Conditional logistic regression was used to estimate odds ratios (ORs) for VTE according to triggers.ResultsAcute infection was registered in 267 (37.8%) of the hazard periods and in 107 (3.8%) of the control periods, corresponding to a high VTE‐risk after infection (OR 24.2, 95% CI 17.2‐34.0), that was attenuated to 15‐fold increased after adjustment for immobilization. The risk was 20‐fold increased after infection without concomitant immobilization, 73‐fold increased after immobilization without infection, and 141‐fold increased with the two combined. The risk of PE was apparently higher after RTIs (OR 48.3, 95% CI 19.4‐120.0) than UTIs (OR 12.6, 95% CI 6.4‐24.7), but diminished in sensitivity analyses excluding uncertain RTI diagnoses.ConclusionsOur findings suggest that hospitalization with infection is a strong VTE‐trigger also in non‐immobilized patients. Infection and immobilization had a synergistic effect on the VTE‐risk.

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“…Magnetic resonance direct thrombus imaging (MRDTI), as a non-contrast-enhanced T1-weighted imaging method, has gained broad interest. Several studies have confirmed a high sensitivity for detecting thrombus in the settings of intracoronary artery 7 , deep vein thrombosis 8 , and pulmonary embolus 9 . By exploiting the short T1 relaxation time of methemoglobin within thrombus, MRDTI depicts subacute thrombus as hyper-intense while maintaining background tissues such as the blood, vessel wall, and surrounding brain tissues as relatively low, iso-intense signal.…”

Section: Introductionmentioning

confidence: 97%

Early Detection and Quantification of Cerebral Venous Thrombosis by Magnetic Resonance Black-Blood Thrombus Imaging

Yang

Duan

Fan

et al. 2016

Stroke

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Background and Purpose Early diagnosis of cerebral venous and sinus thrombosis (CVT) is currently a major clinical challenge. We proposed a novel MR black-blood thrombus imaging technique(MRBTI) for detection and quantification of CVT. Methods MRBTI was performed on 23 patients with proven CVT and 24 patients with negative CVT confirmed by conventional imaging techniques. Patients were divided into two groups based on the duration of clinical onset: ≤ 7 days (group 1); between 7 and 30 days (group 2). Signal-to-noise ratio (SNR) was calculated for the detected thrombus and contrast-to-noise ratio (CNR) was measured between thrombus and lumen, and also between thrombus and brain tisssue. The feasibility of using MRBTI for thrombus volume measurement was explored and total thrombus volume was calculated for each patient. Results In 23 patients with proven CVT, MRBTI correctly identified 113 out of 116 segments with a sensitivity of 97.4%. Thrombus SNR was 153±57 and 261±95 for group 1(n=10) and group 2(n=13), respectively(P<0.01). Thrombus to lumen CNR was 149±57 and 256±94 for group 1 and group 2. Thrombus to brain tissue CNR was 41±36 and 120±63 (P<0.01), respectively. Quantification of thrombus volume was successfully conducted in all patients with CVT, and mean volume of thrombus was 10.5±6.9cc. Conclusions The current findings support that with effectively suppressed blood signal, MRBTI allows selective visualization of thrombus as opposed to indirect detection of venous flow perturbation and can be used as a promising first line diagnostic imaging tool.

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Finding the origin of pulmonary emboli with a total-body magnetic resonance direct thrombus imaging technique

Cited by 97 publications

References 57 publications

The Incidence and Mortality of Thromboembolic Events in Cervical Spine Surgery

The Incidence and Mortality of Thromboembolic Events in Cervical Spine Surgery

Acute infection as a trigger for incident venous thromboembolism: Results from a population‐based case‐crossover study

Early Detection and Quantification of Cerebral Venous Thrombosis by Magnetic Resonance Black-Blood Thrombus Imaging

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