Fu Qing, Cheng Qiguang, Wu Sheng, Kong Xiangchuang
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China.
Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei 430022, P.R. China.
Exp Ther Med. 2020 Apr;19(4):2632-2640. doi: 10.3892/etm.2020.8500. Epub 2020 Feb 7.
The aim of the present study was to evaluate magnetic resonance venography (MRV) scanned by breath-hold volume interpolated body examination with spectral fat saturation (VIBE-fs), combined with Dixon fat-suppressed VIBE (VIBE-Dixon) by using a 1.5T MR scanner for detecting deep venous thrombosis (DVT) compared with duplex sonography. A total of 31 patients with DVT were identified using duplex sonography and were enrolled in the present study for MRV examination, from the inferior vena cava to the ankle level after injection of gadopentetate dimeglumine. Venous segment-to-segment comparison was assessed for DVT detection between MRV and duplex sonography. A total of two radiologists separately performed subjective image quality assessment using a 5-point scale. Cohen's κ coefficient, Wilcoxon rank sum test and intraclass correlation coefficient values were used for statistical analysis. Of the 303 evaluated vein segments, duplex sonography identified 119 (39.3%; 119/303) venous segments with thrombus, while MRV detected 170 (56.1%; 170/303) venous segments with thrombus. The diagnostic agreement rate of DVT between duplex sonography and MRV was poor in the deep femoral vein and anterior tibial veins, while it was excellent in the inferior vena cava (IVC), common iliac vein, external iliac vein, femoral vein, popliteal vein, posterior tibial veins and peroneal veins. In addition, poor reliability was detected in the deep femoral vein, anterior tibial veins and peroneal veins, but good to excellent reliability was observed in IVC, common iliac vein, external iliac vein, femoral vein, popliteal vein and posterior tibial veins. Furthermore, image quality scores of each venous segment between the two radiologists indicated no statistical difference. Therefore, MRV scanned using VIBE-fs for the suprainguinal and VIBE-Dixon for the infrainguinal region may be a useful method for detecting DVT compared with duplex sonography. The results of present study proved this MR protocol to be a beneficial alternative imaging modality for the detection of DVT when duplex sonography is inadequate or not able to be performed.
本研究的目的是评估使用1.5T磁共振扫描仪，通过屏气容积内插体部检查结合频谱脂肪饱和技术（VIBE-fs）进行的磁共振静脉血管造影（MRV），并联合狄克逊脂肪抑制VIBE序列（VIBE-Dixon），与双功超声检查相比用于检测深静脉血栓形成（DVT）的效果。使用双功超声检查共识别出31例DVT患者，并纳入本研究进行MRV检查，在注射钆喷酸葡胺后从下腔静脉至踝关节水平进行扫描。对MRV和双功超声检查在DVT检测方面进行静脉段与段之间的比较评估。两名放射科医生分别使用5分制进行主观图像质量评估。采用科恩κ系数、威尔科克森秩和检验以及组内相关系数值进行统计分析。在303个评估的静脉段中，双功超声检查发现119个（39.3%；119/303）静脉段有血栓，而MRV检测到170个（56.1%；170/303）静脉段有血栓。双功超声检查与MRV在股深静脉和胫前静脉中对DVT的诊断符合率较差，而在下腔静脉（IVC）、髂总静脉、髂外静脉、股静脉、腘静脉、胫后静脉和腓静脉中诊断符合率极佳。此外，在股深静脉、胫前静脉和腓静脉中检测到可靠性较差，但在IVC、髂总静脉、髂外静脉、股静脉、腘静脉和胫后静脉中观察到可靠性良好至极佳。此外，两名放射科医生对各静脉段的图像质量评分无统计学差异。因此，与双功超声检查相比，使用VIBE-fs对腹股沟上区域进行扫描以及使用VIBE-Dixon对腹股沟下区域进行扫描的MRV可能是检测DVT的一种有用方法。本研究结果证明，当双功超声检查不充分或无法进行时，这种MR检查方案是检测DVT的一种有益的替代成像方式。
