The Diagnostic Value of 3-Dimensional Sampling Perfection With Application Optimized Contrasts Using Different Flip Angle Evolutions (SPACE) MRI in Evaluating Lower Extremity Deep Venous Thrombus

Wu, Gang; Xie, Ruyi; Zhang, Xiaoli; Morelli, John N.; Xu, Yan; Zhu, Xiaolei; Li, Xiaoming

doi:10.1097/rli.0000000000000399

Cited by 7 publications

(11 citation statements)

References 26 publications

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“…Clot burden was compared between DANTE-FLASH and MRDTI at the region, limb, and patient levels. The Wilcoxon signed-rank test was used to identify differences in clot burden scores (29). A P value less than 0.05 was considered statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…All images obtained by DANTE-FLASH were reviewed at the same time. One month later, a consensus reading was performed only on the MRDTI images to generate The assessment criteria used to evaluate the clot burden were the same as those used in previous studies (28,29). Specifically, the clot burden of each segment was scored by the radiologists in consensus: 0, patent vein segment; 1, nonocclusive thrombus; 2, subsegmental, occlusive thrombus; and 3, occlusive thrombus of the entire length of a segment.…”

Section: Mr Imagingmentioning

confidence: 99%

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Time-efficient and contrast-free magnetic resonance imaging approach to the diagnosis of deep vein thrombosis on black-blood gradient-echo sequence: a pilot study

Mao¹,

Guan²,

Peng³

et al. 2021

Quant Imaging Med Surg

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Background: Black-blood thrombus imaging (BTI) has shown to be advantageous for the diagnosis of deep vein thrombosis (DVT). However, previous techniques using fast spin echo have a high specific absorption rate. As DANTE (delay alternating with nutation for tailored excitation) black-blood preparation can suppress blood flows over a broad range of velocities, we hypothesized that a DANTE black-blood preparation combined with a fast low-angle shot (FLASH) gradient-echo readout-DANTE-FLASH could be used to diagnose DVT.Methods: Eleven healthy volunteers and 30 suspected DVT patients were recruited to undergo DANTE-FLASH and magnetic resonance direct thrombus imaging (MRDTI). The suspected DVT patients were also examined by ultrasound (US). For the segment level, a total of 1,066 venous vessel segments were analyzed.Using US and MRDTI as the references, the sensitivity (SE), specificity (SP), positive and negative predictive values (PPV and NPV), and accuracy (ACC) of DANTE-FLASH were calculated. To quantitatively compare image quality between DANTE-FLASH and MRDTI, image signal-to-noise ratio (SNR), apparent contrastto-noise ratio (CNR) between muscle and the venous lumen, and the apparent CNR between the thrombus and venous lumen were measured. Additionally, diagnostic confidence, image quality, and clot burden were also evaluated.Results: Using the consensus results of US and MRDTI as a standard reference, the diagnostic SE, SP, PPV, NPV, and ACC of DANTE-FLASH for the 2 readers were 97.0% and 93.2%, 99.0% and 98.2%, 93.4% and 87.9%, 99.6% and 99.0%, and 98.8% and 97.6%, respectively. According to the image quantitative analysis results, DANTE-FLASH demonstrated higher image SNR and CNR than MRDTI.The image quality and diagnostic confidence scores of DANTE-FLASH were higher than MRDTI (3.66±0.44 vs. 3.52±0.52, P<0.001, and 3.84±0.36 vs. 3.76±0.41, P<0.001). There was excellent agreement between DANTE-FLASH and MRDTI on clot burden evaluation.Conclusions: DANTE-FLASH provided better image quality than MRDTI and accurately detected thrombi. It may, therefore, serve as a safe and convenient alternative for the diagnosis of DVT.

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Section: Discussionmentioning

confidence: 99%

Section: Mr Imagingmentioning

confidence: 99%

Time-efficient and contrast-free magnetic resonance imaging approach to the diagnosis of deep vein thrombosis on black-blood gradient-echo sequence: a pilot study

Mao¹,

Guan²,

Peng³

et al. 2021

Quant Imaging Med Surg

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“…The exclusion criteria included: (1) contraindications to MR such as renal insufficiency, pregnancy, claustrophobia, or previous implants performed without confirmed MR safety and (2) lower extremity arterial occlusive diseases. 12 This research was approved by the ethics committees of the 2 study institutions, and written informed consent was obtained in all cases.…”

Section: Methodsmentioning

confidence: 99%

“…[5][6][7][8] Recent studies have described the value of magnetic resonance (MR) black-blood thrombus imaging (BTI) in the diagnosis of thrombus. [9][10][11][12][13] To diagnosis a thrombus, it is necessary to suppress the signal flowing through the blood and to capture the signal of the stationary tissue. Because the concentrations of methemoglobin (MET-Hb) rely on the phase of the DVT, the signal intensity (SI) of the thrombus on the T1-weighted image varies.…”

Section: Introductionmentioning

confidence: 99%

Comparison Between the Diagnostic Performance of 1.5 T and 3.0 T field Strengths for Detecting Deep Vein Thrombosis Using Magnetic Resonance Black-Blood Thrombus Imaging

Huang

et al. 2020

Clin Appl Thromb Hemost

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Background: Magnetic resonance (MR) black-blood thrombus imaging (BTI) is an accurate diagnostic technique for detecting deep vein thrombosis (DVT) but to date there have been no studies comparing the diagnostic performance and consistency of this technique at different field strengths. In this study, we evaluated and compared the diagnostic performance of BTI for detecting DVT at 1.5 T and 3.0 T field strengths. Methods: A total of 40 patients with DVT were enrolled in this study from November 2015 up to October 2018. All patients underwent BTI, a contrast-free T1-weighted MR imaging technique for detecting DVT, and contrast-enhanced MR venography (CE-MRV) at 1.5 T or 3.0 T field strengths. The MR data analyses used 1160 segments from the venous lumen of the 40 patients. The signal-to-noise ratio and contrast-to-noise ratio between thrombus and muscle/lumen were calculated to compare BTI at 1.5 T or 3.0 T to determine the image performance for thrombus detection at 1.5 T or 3.0 T. Two physicians blinded to the study evaluated all BTI images and calculated the overall sensitivity (SE), specificity (SP), positive predictive value (PPV) and negative predictive value (NPV), accuracy, and diagnostic consistency at 1.5 T and 3.0 T. These images and values were compared to control CE-MRV images that had been obtained by 2 senior physicians and used as reference standards. In addition, the reliability and consistency of diagnoses between observers were also evaluated. Results: Two study-blind physicians reviewed all BTI images to diagnose thrombus and to determine SE, SP, PPV, NPV, and accuracy. There were no statistical differences in SE, SP, PPV, NPV, or accuracy between the 1.5 T and 3.0 T groups. Conclusions: Black-blood thrombus imaging has high SE, SP, and accuracy for DVT diagnosis both at 1.5 T and 3.0 T field strengths. This noninvasive diagnostic technique, which does not require the use of contrast agents, can be widely used in the clinical screening of DVT and follow-up after treatment.

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“…However, DSA is invasive and expensive, and exposes patients to ionizing radiation. [2,3] Time resolved magnetic resonance angiography (MRA) is thus developed to serve as a non-invasive alternative to DSA. Time resolved magnetic resonance angiography with interleaved stochastic trajectories (TWIST) is reported to provide adequate temporal and spatial resolution for generating arterial images without venous pollution, [4–6] so is feasible for identification of feeding arteries and AVS.…”

Section: Introductionmentioning

confidence: 99%

Feeding arteries and arteriovenous shunt for discrimination of soft tissue tumors

Yang

2019

Medicine

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Time resolved magnetic resonance angiography with interleaved stochastic trajectories (TWIST) allows for identification of tumor feeding arteries and arteriovenous shunt (AVS). We used TWIST to obtain number of feeding arteries (NFA) and detect AVS for 43 cases of pathology-confirmed soft tissue tumors. We compared normalized number of feeding arteries (nNFA) and AVS between malignant and benign tumors, and found nNFA was significantly greater in malignant tumors versus benign tumors (2.1 vs 1.3, P < .05). The incidence of AVS was significantly higher in malignant tumors versus benign tumors (87.5% vs 10.5%, P < .05). TWIST derived nNFA and AVS could be useful in the discrimination of benign and malignant soft tissue tumors.

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The Diagnostic Value of 3-Dimensional Sampling Perfection With Application Optimized Contrasts Using Different Flip Angle Evolutions (SPACE) MRI in Evaluating Lower Extremity Deep Venous Thrombus

Abstract: Non-contrast-enhanced 3-dimensional SPACE magnetic resonance imaging is highly accurate in detecting lower extremity DVT and reliable in the evaluation of clot burden. SPACE could serve as an important alternative for patients in whom US cannot be performed.

Cited by 7 publications

References 26 publications

Time-efficient and contrast-free magnetic resonance imaging approach to the diagnosis of deep vein thrombosis on black-blood gradient-echo sequence: a pilot study

Time-efficient and contrast-free magnetic resonance imaging approach to the diagnosis of deep vein thrombosis on black-blood gradient-echo sequence: a pilot study

Comparison Between the Diagnostic Performance of 1.5 T and 3.0 T field Strengths for Detecting Deep Vein Thrombosis Using Magnetic Resonance Black-Blood Thrombus Imaging

Feeding arteries and arteriovenous shunt for discrimination of soft tissue tumors

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