title: Simultaneous MR arteriography and venography with blood pool contrast agent detects deep venous thrombosis in suspected arterial disease.
abstract: OBJECTIVE
  The purpose of this study was to investigate the prevalence of incidental deep venous thrombosis (DVT) in patients with clinically suspected peripheral arterial occlusive disease (PAOD) using contrast-enhanced MR angiography (MRA) with a blood pool contrast agent.
  
  
  METHODS
  Two hundred fifty-nine MRA examinations with blood pool contrast agent in 245 consecutive patients (161 men; age range, 36-92 years), yielding a total of 4102 assessable arterial and venous vessel segments, were assessed with regard to the rate of incidentally observed acute and organized DVT and arterial stenosis grades. Incidental DVT was confirmed using duplex ultrasound. Contralateral nondiseased veins served as internal controls. The relationship between PAOD stages and acute and organized DVT was investigated using chi-square tests and a Mann-Whitney U test.
  
  
  RESULTS
  Arterial stenosis grading using MRA with blood pool contrast agent revealed less than 50% luminal stenosis in 78% of segments (3199/4102), 50% or greater stenosis in 8% of segments (317/4102), and occlusion in 14% of segments (586/4102). Incidental DVT was observed in 26 of 245 patients (11%) (acute DVT was seen in 10 patients and 26 segments; organized DVT was seen in 17 patients and 35 segments; and one patient had both acute and organized DVT). All incidentally diagnosed cases of DVT were confirmed by duplex ultrasound. Internal controls revealed no false-positive or -negative findings (26 patients and 172 segments). Incidental acute DVT was significantly more common among patients without arterial stenosis greater than 50% (p < 0.05). Otherwise, there was no significant relationship between Fontaine PAOD stages and the occurrence of acute (p = 0.688) or organized (p = 0.995) DVT.
  
  
  CONCLUSIONS
  Incidental DVT was prevalent in 11% of patients with clinically suspected PAOD. MRA with blood pool contrast agent has a potential role in the simultaneous assessment of arteries and veins and can detect concomitant venous disease affecting therapeutic management.
authors.affiliation: Department of Radiology, University of Bonn, Germany. Dariusch.Hadizadeh@ukb.uni-bonn.de
authors.forename: Dariusch R
authors.initials: DR
authors.lastname: Hadizadeh
authors.forename: Guido M
authors.initials: GM
authors.lastname: Kukuk
authors.forename: Ute L
authors.initials: UL
authors.lastname: Fahlenkamp
authors.forename: Josephine
authors.initials: J
authors.lastname: Pressacco
authors.forename: Christian
authors.initials: C
authors.lastname: Schäfer
authors.forename: Eberhard
authors.initials: E
authors.lastname: Rabe
authors.forename: Arne
authors.initials: A
authors.lastname: Koscielny
authors.forename: Frauke
authors.initials: F
authors.lastname: Verrel
authors.forename: Hans H
authors.initials: HH
authors.lastname: Schild
authors.forename: Winfried A
authors.initials: WA
authors.lastname: Willinek
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D016009:Chi-Square Distribution; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D033162:Incidental Findings; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D015995:Prevalence; D018709:Statistics, Nonparametric; D018616:Ultrasonography, Doppler, Duplex; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D005682:Gadolinium; C109932:gadofosveset trisodium