Combined magnetic resonance imaging of deep venous thrombosis and pulmonary arteries after a single injection of a blood pool contrast agent.
OBJECTIVE
Agreement rate between magnetic resonance imaging (MRI) and Doppler ultrasound (DUS) for the detection of deep vein thrombosis (DVT) in the lower extremities was attempted by using the intravascular MRI contrast agent gadofosveset trisodium. The potential of this method to detect pulmonary embolism (PE) was also evaluated.


METHODS
Forty-three consecutive inpatients with ultrasound-confirmed DVT but no clinical signs of PE were prospectively enrolled in this feasibility study. MRI was performed after a single injection of gadofosveset trisodium. The pulmonary arteries were imaged using a 3D Fast Low Angle Shot (FLASH) gradient recalled echo sequence. Additionally, pulmonary arteries, abdominal veins, pelvic and leg veins were imaged using a fat-suppressed 3D gradient echo Volume Interpolated Breath-hold Examination (VIBE FS).


RESULTS
Gadofosveset trisodium-enhanced MRI detected more thrombi in the pelvic region, upper leg and lower leg than the initial DUS. In addition, PE was detected in 16 of the 43 DVT patients (37%).


CONCLUSIONS
This study shows the feasibility of a combined protocol for the MRI diagnosis of DVT and PE using gadofosveset trisodium. This procedure is not only more sensitive in detecting DVT compared to standard DUS, but is also able to detect PE in asymptomatic patients.
Hansch
Andreas
A
Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller-University Jena, Jena, Germany. andreas.hansch@med.uni-jena.de
Betge
Stefan
S
Poehlmann
Gunther
G
Neumann
Steffi
S
Baltzer
Pascal
P
Pfeil
Alexander
A
Waginger
Matthias
M
Boettcher
Joachim
J
Kaiser
Werner A
WA
Wolf
Gunter
G
Mentzel
Hans-Joachim
HJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D005682:Gadolinium / Q000008:administration & dosage*; D006801:Humans; D007269:Injections, Intra-Arterial; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage*; D011651:Pulmonary Artery / Q000473:pathology; D011655:Pulmonary Embolism / Q000150:complications* / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D020246:Venous Thrombosis / Q000150:complications* / Q000473:pathology*
D003287:Contrast Media; D009942:Organometallic Compounds; D005682:Gadolinium; C109932:gadofosveset trisodium