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Isolated calf vein thrombosis: comparison of MR venography and conventional venography after initial sonography in symptomatic patients.

Abstract：

RATIONALE AND OBJECTIVES:The authors performed this study to compare magnetic resonance (MR) venography and conventional venography in the diagnosis of deep venous thrombosis (DVT) in the calf after sonography. MATERIALS AND METHODS:Sonography was performed in 595 patients who were suspected of having lower-extremity DVT. Patients with positive above-knee duplex sonograms, allergy to iodinated contrast material, renal insufficiency, or cardiac pacemakers and patients who were obese were excluded. The remaining 73 patients were asked to undergo MR venography and conventional venography. All studies were to be performed within 48 hours of the clinical diagnosis and according to standard clinical practice. Images were interpreted by radiologists who were blinded to the results of other modalities. Two separate analyses were performed: one in which conventional venography was used as the standard of reference, and one in which the presence of at least two positive studies for thrombus was considered diagnostic. RESULTS:Although 36 patients agreed to participate in the study, only 14 underwent MR venography and conventional venography within 48 hours of the clinical diagnosis. With use of any two positive studies for confirmation, acute DVT was diagnosed in three patients. Conventional venography depicted two of the three cases, whereas sonography and MR venography each depicted all three. The findings were concordant in only five of the 14 patients. CONCLUSION:Moderate discrepancy among modalities was demonstrated. This suggests radiologists should undertake comparisons among these three modalities for the detection of calf DVT. In patients with a high clinical suspicion, a second modality may be useful if the initial study is negative.

journal_name

Acad Radiol

journal_title

Academic radiology

authors

Sica GT,Pugach ME,Koniaris LS,Goldhaber SZ,Polak JF,Mukerjee A,Tempany CM

doi

10.1016/s1076-6332(03)80764-x

keywords:

subject

Has Abstract

pub_date

2001-09-01 00:00:00

pages

856-63

issue

eissn

1076-6332

issn

1878-4046

journal_volume

pub_type

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Isolated calf vein thrombosis: comparison of MR venography and conventional venography after initial sonography in symptomatic patients.