Pelvic and lower extremity veins: contrast-enhanced three-dimensional MR venography with a dedicated vascular coil-initial experience.
OBJECTIVE
To assess the performance of three-dimensional (3D) magnetic resonance (MR) venography of the pelvis and lower extremities in patients without acute deep venous thrombosis by using a lower extremity vascular coil and pedal injection of paramagnetic contrast material.


METHODS
Conventional and MR venography were performed in 35 legs in 25 patients referred for evaluation of varicosities (n = 8) and postthrombotic changes (n = 7) and assessment of the great saphenous veins prior to bypass surgery (n = 10). Injection of 120 mL of diluted (1:15) gadopentetate dimeglumine into a pedal vein was performed manually at a rate of 1 mL/sec, and 3D gradient-recalled echo data sets of the upper and lower veins were collected. Conventional and MR venographic images were analyzed separately in a blinded fashion.


RESULTS
MR image quality was comparable to that of conventional venograms. Varicose changes of the great and small saphenous veins (sensitivity, 94% [44 of 47]; specificity, 96% [89 of 93]) were assessed as reliably as their status before bypass surgery (sensitivity, 98% [53 of 54]; specificity, 92% [47 of 51]). Postthrombotic changes were diagnosed with a sensitivity of 100% [13 of 13] and a specificity of 98% [88 of 90].


CONCLUSIONS
Direct 3D MR venography comprehensively displays the lower extremity venous system and permits assessment of postthrombotic and varicose changes and the bypass suitability of the saphenous vein.
Ruehm
S G
SG
Institute of Diagnostic Radiology, University Hospital Zurich, Switzerland.
Wiesner
W
W
Debatin
J F
JF
D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007275:Injections, Intravenous; D007866:Leg / Q000098:blood supply*; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000098:blood supply*; D010690:Phlebography; D011186:Postphlebitic Syndrome / Q000175:diagnosis; D015203:Reproducibility of Results; D012501:Saphenous Vein / Q000473:pathology; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D014648:Varicose Veins / Q000175:diagnosis*; D014680:Veins / Q000473:pathology; D020246:Venous Thrombosis / Q000175:diagnosis
D003287:Contrast Media; D019786:Gadolinium DTPA