Abstract
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.
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Acknowledgements
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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Appendix
Appendix
Search strategy
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1.
exp Venous Thrombosis/
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deep vein thrombosis.tw.
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3.
phlebothrombosis.tw.
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venous thrombos$.tw.
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deep venous thrombosis.tw.
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DVT.tw.
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or/1–6
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exp “Sensitivity and Specificity”/
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exp Diagnostic Errors/
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Reference Values/
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Reproducibility of Results/
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likelihood functions/
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specificity.mp. [mp=title, abstract, cas registry/ec number word, mesh subject heading]
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sensitivity.mp.
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false negative$.mp.
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false positive$.mp.
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true negative$.mp.
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true positive$.mp.
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predictive value$.mp.
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reproducibility.mp.
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ROC curve.mp.
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Diagnos$.mp.
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reference value$.mp.
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likelihood function$.mp.
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likelihood ratio$.mp.
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or/8–25
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exp Magnetic Resonance Imaging/
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chemical shift imaging.tw.
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mr tomography.tw.
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mri.tw.
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magnetic resonance imaging.tw.
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magnetization transfer contrast imaging.tw.
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nmr.tw.
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proton spin tomography.tw.
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zeugmatography.tw.
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or /27–35
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7 and 26 and 36
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Sampson, F.C., Goodacre, S.W., Thomas, S.M. et al. The accuracy of MRI in diagnosis of suspected deep vein thrombosis: systematic review and meta-analysis. Eur Radiol 17, 175–181 (2007). https://doi.org/10.1007/s00330-006-0178-5
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DOI: https://doi.org/10.1007/s00330-006-0178-5
Keywords
- Deep vein thrombosis
- Systematic review
- Meta-analysis
- Magnetic resonance imaging