[Characterization of an experimental venous thrombus model with MRI, phlebography and histology].
BACKGROUND
Several magnetic resonance (MR) techniques designed to demonstrate the characteristic signal intensity of blood degeneration products of thrombi have been suggested, but the effect of thrombus organization on the MR display, in particular with regard to its temporal evolution, remains to be determined. It is the purpose of this study to develop a stagnation thrombus model in rabbits and to characterize thrombus at different ages with two (MR) imaging techniques, phlebography and histology.


METHODS
Venous stagnation thrombi were induced in the external jugular veins of rabbits using a minimally invasive radiological technique to produce artificial embolic vascular occlusion and hypercoagulability. Twenty-five animals were divided into 5 groups of 5 animals, and each group underwent 1.5 T MR imaging at 1, 3, 5, 7 and 9 days after thrombus induction using a T1-weighted magnetization-prepared rapid gradient-echo sequence (MP-RAGE: TR 10.4 msec, TE 4.0 msec, FA 15 degrees ) and a T2-weighted fast low-angle shot sequence (FLASH: TR 54 msec, TE 18 msec, FA 15 degrees ). The thrombus length was measured on the T1-weighted images. Thrombus conspicuity, signal intensity, and heterogeneity on T2* weighted images were described using visual scales. Radiographic venography and histology served as reference methods.


RESULTS
Thrombi were successfully induced in all animals. The overall thrombus length decreased from 43 +/- 9 (day 1 after induction) to 23 +/- 4 mm (day 9). On 3D-reconstructions of the T1-weighted images, the visible portion of the true thrombus length relative to the overall thrombus length was 0.16 +/- 0.3 (day 1), 0.24 +/- 0.3 (day 3), 0.38 +/- 0.5 (day 5), 0.06 +/- 0.1 (day 7) and 0.00 (day 9). Sixteen of 25 thrombi were detectable with the T2*-weighted technique. The overall thrombus signal intensity decreased with the age of the thrombus from day 1 to day 9. The histological evaluation showed that the rabbit thrombi closely resemble human thrombi morphologically.


CONCLUSIONS
The thrombus model closely resembles the human venous stagnation thrombus of different organizational stages. With state-of-the-art MRI techniques, thrombi were only partially displayed with the visibility depending on thrombus age. The model may be suitable for evaluating new and potentially more effective MRI techniques for improved thrombus visualization.
Schmitz
S A
SA
Klinik und Hochschulambulanz für Radiologie und Nuklearmedizin, Charité, Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin. Stephan.Schmitz@imperial.ac.uk
Schiffler
S
S
Gust
R
R
Winterhalter
S
S
Coupland
S E
SE
Wolf
K-J
KJ
D000818:Animals; D003287:Contrast Media; D003627:Data Interpretation, Statistical; D004195:Disease Models, Animal; D021621:Imaging, Three-Dimensional; D007601:Jugular Veins / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D010690:Phlebography; D011817:Rabbits; D013997:Time Factors; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000473:pathology*
D003287:Contrast Media