The accuracy of MRI in diagnosis of suspected deep vein thrombosis: systematic review and meta-analysis
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Magnetic resonance imaging (MRI) may be used to diagnose deep vein thrombosis (DVT) in patients for whom ultrasound examination is inappropriate or unfeasible. We undertook a systematic review of the literature and meta-analysis to estimate the diagnostic accuracy of MRI for DVT. We searched databases of medical literature and citation lists of retrieved articles. We selected studies that compared MRI with a reference standard in patients with suspected DVT or suspected pulmonary embolus, or high-risk asymptomatic patients. Data were analysed by random effects meta-analysis. We included 14 articles in the meta-analysis. Most compared MRI with venography in patients with clinically suspected DVT. The pooled estimate of sensitivity was 91.5% (95% CI: 87.5–94.5%) and the pooled estimate of specificity was 94.8% (95% CI: 92.6–96.5%). Sensitivity for proximal DVT was higher than sensitivity for distal DVT (93.9% versus 62.1%). However, pooled estimates should be interpreted with caution as estimates of both sensitivity and specificity were subject to significant heterogeneity (P<0.001). Individual studies reported sensitivity ranging from zero to 100%, while specificity ranged from 43 to 100%. MRI has equivalent sensitivity and specificity to ultrasound for diagnosis of DVT, but has been evaluated in many fewer studies, using a variety of different techniques.
KeywordsDeep vein thrombosis Systematic review Meta-analysis Magnetic resonance imaging
The authors would like to thank Kathryn Paulucy for her clerical assistance and Angie Ryan for her help with the literature searches. The United Kingdom Health Technology Assessment R&D Programme funded this project (reference number 02/03/01). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the UK Department of Health.
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