title: Abdominopelvic and lower extremity deep venous thrombosis: evaluation with contrast-enhanced MR venography with a blood-pool agent.
abstract: OBJECTIVE
  The purpose of this article is to evaluate contrast-enhanced (CE) MR venography (MRV) with a blood-pool agent for detection of abdominopelvic and lower extremity deep venous thrombosis (DVT) compared with a conventional unenhanced gradient-recalled echo (GRE) MRV technique.
  
  
  METHODS
  This retrospective study was performed on 30 patients (mean age, 52.7 years; 15 men and 15 women) referred for MRV between March 2010 and November 2010 for evaluation of lower extremity or abdominopelvic DVT. All patients underwent a GRE sequence followed by a CE T1-weighted sequence with gadofosveset, a blood-pool agent. The abdominopelvic and lower extremity venous system was divided into 13 segments. The presence of acute or chronic DVT was assessed by six radiologists, as well as qualitative and quantitative assessments of each venous segment. Image acquisition and interpretation times were also tabulated.
  
  
  RESULTS
  The sensitivity and specificity for acute DVT were 91.0% and 99.8%, respectively, on CE MRV compared with 80.8% and 95.8%, respectively, on GRE MRV (p = 0.077 and p < 0.001). The sensitivity and specificity for chronic DVT were 84.4% and 98.4%, respectively, on CE MRV and 64.5% and 95.6%, respectively, on GRE MRV (p < 0.001 for both). Subjective ratings of vein visualization, signal homogeneity, and confidence pertaining to DVT diagnosis were significantly higher with the CE images (p < 0.001). The contrast-to-noise ratio for CE images was similar or significantly higher for all venous segments. Image acquisition and radiologist interpretation times on the CE studies were decreased (p < 0.001).
  
  
  CONCLUSIONS
  Gadofosveset-enhanced MRV had equal or higher sensitivity and specificity for detection of DVT than did GRE MRV, with decreased time for image acquisition and interpretation.
authors.affiliation: Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710, USA.
authors.forename: Steven Y
authors.initials: SY
authors.lastname: Huang
authors.forename: Charles Y
authors.initials: CY
authors.lastname: Kim
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Miller
authors.forename: Rajan T
authors.initials: RT
authors.lastname: Gupta
authors.forename: Mark L
authors.initials: ML
authors.lastname: Lessne
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Horvath
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Boll
authors.forename: Paul D
authors.initials: PD
authors.lastname: Evans
authors.forename: Nicholas T
authors.initials: NT
authors.lastname: Befera
authors.forename: Pranay
authors.initials: P
authors.lastname: Krishnan
authors.forename: Johanna L
authors.initials: JL
authors.lastname: Chan
authors.forename: Elmar M
authors.initials: EM
authors.lastname: Merkle
mesh_terms: D000005:Abdomen / Q000098:blood supply*; D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D005919:Glomerular Filtration Rate; D006801:Humans; D007866:Leg / Q000098:blood supply*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D020246:Venous Thrombosis / Q000175:diagnosis*
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D005682:Gadolinium; C109932:gadofosveset trisodium