European Radiology

, Volume 21, Issue 2, pp 318–325

Combined magnetic resonance imaging of deep venous thrombosis and pulmonary arteries after a single injection of a blood pool contrast agent

  • Andreas Hansch
  • Stefan Betge
  • Gunther Poehlmann
  • Steffi Neumann
  • Pascal Baltzer
  • Alexander Pfeil
  • Matthias Waginger
  • Joachim Boettcher
  • Werner A. Kaiser
  • Gunter Wolf
  • Hans-Joachim Mentzel
Contrast Media

Abstract

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.

Material and 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%).

Conclusion

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.

Keywords

MRI Deep venous thrombosis Pulmonary embolism Pulmonary arteries Blood pool MR contrast agent Gadofosveset trisodium 

Supplementary material

330_2010_1918_MOESM1_ESM.mpg (3.8 mb)
Movie 1MRI of the lower extremity (3D volumetric interpolated breath-hold sequence (VIBE) with fat suppression; TR/TE, 4.1/1.4) showing a thrombus in the left superficial femoral vein and popliteal vein. (MPG 3928 kb)
330_2010_1918_MOESM2_ESM.mpg (5.7 mb)
Movie 2MRI of the lung (3D Fast Low Angle Shot (FLASH) gradient recalled echo sequence, TR/TE: 2.7 ms/2.4) depicting a large embolus in the left pulmonary artery (arrow). Note the solitary, sharp-edged round liver lesion in the right lobe with cystic appearance (arrowhead). (MPG 5803 kb)

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Copyright information

© European Society of Radiology 2010

Authors and Affiliations

  • Andreas Hansch
    • 1
  • Stefan Betge
    • 2
  • Gunther Poehlmann
    • 2
  • Steffi Neumann
    • 1
  • Pascal Baltzer
    • 1
  • Alexander Pfeil
    • 3
  • Matthias Waginger
    • 1
  • Joachim Boettcher
    • 4
  • Werner A. Kaiser
    • 1
  • Gunter Wolf
    • 3
  • Hans-Joachim Mentzel
    • 1
  1. 1.Institute of Diagnostic and Interventional RadiologyFriedrich-Schiller-University JenaJenaGermany
  2. 2.Department of Internal Medicine IFriedrich-Schiller-University JenaJenaGermany
  3. 3.Department of Internal Medicine IIIFriedrich-Schiller-University JenaJenaGermany
  4. 4.Institute of Diagnostic and Interventional RadiologySRH Klinikum GeraGeraGermany

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