title: Combined MR direct thrombus imaging and non-contrast magnetic resonance venography reveal the evolution of deep vein thrombosis: a feasibility study.
abstract: OBJECTIVE
  Lower limb deep venous thrombosis (DVT) is a common condition with high morbidity and mortality. The aim of the study was to investigate the temporal evolution of the acute thrombus by magnetic resonance imaging (MRI) and its relationship to venous recanalization in patients with recurrent DVTs.
  
  
  METHODS
  Thirteen patients with newly diagnosed lower limb DVTs underwent MRI with non-contrast MR venography (NC-MRV) and MR direct thrombus imaging (MR-DTI), an inversion-recovery water-selective fast gradient-echo acquisition. Imaging was performed within 7 days of the acute thrombotic event, then at 3 and 6 months.
  
  
  RESULTS
  By 3 months from the thrombotic event a third of the thrombi had resolved and by 6 months about half of the cases had resolved on the basis of vein recanalisation using NC-MRV. On the initial MR-DTI acute thrombus was clearly depicted by hyperintense signal, while the remaining thrombi were predominantly low signal at 3 and 6 months. Some residual thrombi contained small and fragmented persisting hyperintense areas at 3 months, clearing almost completely by 6 months.
  
  
  CONCLUSIONS
  Our study suggests that synergistic venous assessment with combined NC-MRV and MR-DTI is able to distinguish acute venous thrombosis from the established (old) or evolving DVT detected by ultrasound.
  
  
  CONCLUSIONS
  • MRI can distinguish between acute and evolving or chronic lower limb DVT • Two advanced MRI techniques can follow the evolution of lower limb DVT • MRI could be used to avoid an incorrect diagnosis of recurrent DVT • MRI could help avoid the risks and complications of lifelong anticoagulation therapy.
authors: Department of Radiology, Addenbrooke's Hospital, Cambridge, UK. im391@cam.ac.uk.|Department of Radiology, University of Cambridge, Cambridge, UK. im391@cam.ac.uk.
authors: I A
authors: IA
authors: Mendichovszky
authors: Department of Radiology, Addenbrooke's Hospital, Cambridge, UK.
authors: A N
authors: AN
authors: Priest
authors: Department of Radiology, Addenbrooke's Hospital, Cambridge, UK.
authors: D J
authors: DJ
authors: Bowden
authors: Department of Radiology, Addenbrooke's Hospital, Cambridge, UK.
authors: S
authors: S
authors: Hunter
authors: Department of Radiology, Addenbrooke's Hospital, Cambridge, UK.
authors: I
authors: I
authors: Joubert
authors: Department of Radiology, Addenbrooke's Hospital, Cambridge, UK.
authors: S
authors: S
authors: Hilborne
authors: Department of Radiology, Addenbrooke's Hospital, Cambridge, UK.
authors: M J
authors: MJ
authors: Graves
authors: Department of Haematology, Addenbrooke's Hospital, Cambridge, UK.
authors: T
authors: T
authors: Baglin
authors: Department of Radiology, Addenbrooke's Hospital, Cambridge, UK.|Department of Radiology, University of Cambridge, Cambridge, UK.
authors: D J
authors: DJ
authors: Lomas
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply / Q000473:pathology; D018810:Magnetic Resonance Angiography / Q000379:methods; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D010690:Phlebography / Q000379:methods; D011152:Popliteal Vein / Q000473:pathology; D012008:Recurrence; D020246:Venous Thrombosis / Q000473:pathology*; D055815:Young Adult
keywords: Clinical decision-making; Diagnosis; Longitudinal study; Magnetic resonance imaging; Venous thrombosis