title: Three-dimensional black-blood T1-weighted turbo spin-echo techniques for the diagnosis of deep vein thrombosis in comparison with contrast-enhanced magnetic resonance imaging: a pilot study.
abstract: OBJECTIVE
  The objective of this study was to evaluate the feasibility of a novel 3-dimensional turbo spin-echo technique with isotropic resolution for the diagnosis of deep vein thrombosis (DVT) in comparison with contrast-enhanced magnetic resonance imaging (CE-MRI) and sonography.
  
  
  METHODS
  Thirteen patients (8 males, 17-93 years) with proven DVT in duplex ultrasound (n = 11) or with pulmonary embolism and suspected to have DVT (n = 2) were consecutively imaged at 3.0 T with 1.2-mm isotropic-resolution volumetric isotropic turbo spin-echo acquisition (VISTA). Sensitivity (SE), specificity (SP), positive and negative predictive values (PPV and NPV, respectively), Cohen κ, as well as accuracy of VISTA-MRI were calculated and compared with CE-MRI and sonography as a standard of reference. Image quality and diagnostic confidence were assessed on a 4-point scale.
  
  
  RESULTS
  Image quality and diagnostic confidence level of VISTA-MRI and CE-MRI were comparable (3.54 vs 3.55 and 3.80 vs 3.77; both P values are nonsignificant). Using CE-MRI as the criterion standard, there was a high agreement between the CE-MRI and the 3-dimensional VISTA examinations for the detection of DVT, with κ of 0.89 for reader 1 and κ of 0.88 for reader 2 (both P < 0.001). The SE, SP, PPV, NPV, as well as accuracy of VISTA-MRI were 92.5%, 97.9%, 89.3%, 98.6%, and 97.1% for reader 1 as well as 90.7%, 97.9%, 89.1%, 98.3%, and 96.8% for reader 2. For both readers, combined comparison of VISTA-MRI and sonography resulted in an SE, SP, PPV, and NPV of 77.8%, 94.8%, 85.4%, and 91.6%, respectively.
  
  
  CONCLUSIONS
  Volumetric isotropic turbo spin-echo acquisition magnetic resonance imaging can be used to diagnose DVT with good to excellent agreement compared with CE-MRI and sonography. It might be useful when contrast media is prohibited and in patients with suspected thrombosis of the iliac veins, which can be hard to detect with sonography.
authors.affiliation: From the *Institute for Clinical Radiology, Hospitals of the Ludwig-Maximilians-University of Munich, Munich; †Philips Healthcare, Hamburg; and ‡Division of Vascular Medicine, Medical Clinic and Policlinic IV, Hospitals of the Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Karla Maria
authors.initials: KM
authors.lastname: Treitl
authors.forename: Marcus
authors.initials: M
authors.lastname: Treitl
authors.forename: Hendrik
authors.initials: H
authors.lastname: Kooijman-Kurfuerst
authors.forename: Nora N
authors.initials: NN
authors.lastname: Kammer
authors.forename: Eva
authors.initials: E
authors.lastname: Coppenrath
authors.forename: Elena
authors.initials: E
authors.lastname: Suderland
authors.forename: Michael
authors.initials: M
authors.lastname: Czihal
authors.forename: Ulrich
authors.initials: U
authors.lastname: Hoffmann
authors.forename: Maximilian F
authors.initials: MF
authors.lastname: Reiser
authors.forename: Tobias
authors.initials: T
authors.lastname: Saam
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D009942:Organometallic Compounds; D010865:Pilot Projects; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D020246:Venous Thrombosis / Q000175:diagnosis*; D055815:Young Adult
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; C072417:gadoterate meglumine