Diffusion weighted cardiovascular magnetic resonance imaging for discriminating acute from non-acute deep venous Thrombus.

BACKGROUND

The importance of discriminating acute from non-acute thrombus is highlighted. The study aims to investigate the feasibility of readout-segmented diffusion weighted (DW) cardiovascular magnetic resonance (CMR) for discrimination of acute from non-acute deep venous thrombus (DVT).

METHODS

For this prospective study from December 2015 to December 2017, 85 participants (mean age = 53 years, age range = 3474) with DVT of lower extremities underwent readout-segmented DW CMR. DVT of ≤14 days were defined as acute (n = 55) and > 14 days as non-acute (n = 30). DVT visualization on b = 0, b = 800, and apparent diffusion coefficient (ADC) images were assessed using a 4-point scale (03, poor~excellent). DW CMR parameters were measured using region of interest (ROI). Relative signal intensity (rSI) and ADC were compared between acute and non-acute DVT using a Mann Whitney test. Sensitivity and specificity for ADC and rSI were calculated.

RESULTS

ADC maps had higher visualization scores than b = 0 and b = 800 images (2.7 ± 0.5, 2.5 ± 0.6, and 2.4 ± 0.6 respectively, P<0.05). The mean ADC was higher in acute DVT than non-acute DVT (0.56 ± 0.17 × 10 vs. 0.22 ± 0.12 × 10 mm/s, P<0.001). Using 0.32 × 10 mm/s as the cutoff, sensitivity and specificity for ADC to discriminate acute from non-acute DVT were 93 and 90% respectively. Sensitivity and specificity were 73 and 60% for rSI on b = 0, and 75 and 63% for rSI on b = 800.

CONCLUSIONS

Readout segmented diffusion-weighted CMR derived ADC distinguishes acute from non-acute DVT.

TRIAL REGISTRATION

This study is retrospectively registered.

TRIAL REGISTRATION NUMBER

HUST-TJH-2015-146 .