Carpenter J P, Holland G A, Baum R A, Owen R S, Carpenter J T, Cope C
Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia.
J Vasc Surg. 1993 Nov;18(5):734-41. doi: 10.1067/mva.1993.49364.
Contrast venography is the gold standard for diagnosis in deep venous thrombosis (DVT); however, this technique is invasive and requires the use of potentially hazardous contrast agents. Although duplex Doppler ultrasonography is accurate in the evaluation of lower extremity DVT, it is less accurate in the assessment of the pelvic and intraabdominal veins. Magnetic resonance venography (MRV) has recently been developed, and our purpose was to determine whether MRV could accurately demonstrated DVT when compared with duplex scanning and contrast venography.
Eighty-five patients underwent contrast venography and MRV from the inferior vena cava to the popliteal veins to rule out DVT. Thirty-three of these patients also underwent duplex scanning. Blinded readings of these studies were compared for the presence or absence and extent of venous thrombosis.
DVT was documented by contrast venography in 27 (27%) venous systems. Results of MRV and contrast venography were identical in 98 (97%) of 101 venous systems, whereas results of duplex scanning and contrast venography were identical in 40 (98%) of 41 venous systems. All DVTs identified by contrast venography were detected by MRV and duplex scanning. The discrepancies were due to false-positive MRV (3) and duplex scanning (1) results. When compared with contrast venography, MRV had a sensitivity of 100%, specificity of 96%, positive predictive value of 90%, and negative predictive value of 100%. For duplex scanning the sensitivity was 100%, specificity was 96%, positive predictive value was 94%, and negative predictive value was 100%.
It is concluded that MRV is an accurate noninvasive venographic technique for the detection of DVT.
静脉造影是诊断深静脉血栓形成（DVT）的金标准；然而，该技术具有侵入性，且需要使用有潜在危害的造影剂。虽然双功多普勒超声在评估下肢DVT方面准确，但在评估盆腔和腹内静脉时准确性较低。磁共振静脉造影（MRV）最近已得到发展，我们的目的是确定与双功扫描及静脉造影相比，MRV能否准确显示DVT。
85例患者接受了从下腔静脉至腘静脉的静脉造影和MRV检查以排除DVT。其中33例患者还接受了双功扫描。对这些检查进行盲法判读，比较有无静脉血栓形成及其范围。
静脉造影证实27个（27%）静脉系统存在DVT。101个静脉系统中，98个（97%）的MRV和静脉造影结果相同，而41个静脉系统中，40个（98%）的双功扫描和静脉造影结果相同。静脉造影发现的所有DVT均被MRV和双功扫描检测到。差异是由于MRV（3例）和双功扫描（1例）出现假阳性结果。与静脉造影相比，MRV的敏感性为100%，特异性为96%，阳性预测值为90%，阴性预测值为100%。双功扫描的敏感性为100%，特异性为96%，阳性预测值为94%，阴性预测值为100%。
得出结论，MRV是一种用于检测DVT的准确无创静脉造影技术。
