scholarly journals Triggered Angiography Non-contrast-enhanced Sequence Magnetic Resonance Imaging: Objective Figures in Differentiation Between Acute and Chronic Deep Venous Thrombosis in the Lower Extremities

2019 ◽  
Vol 58 (6) ◽  
pp. e623
Author(s):  
Chih-Chen Kao ◽  
Chien-Wei Chen ◽  
Yuan-Hsi Tseng ◽  
Yuan-Hsiung Tsai ◽  
Shih-Chung Wang ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Lower Extremities ◽  
Resonance Imaging ◽  
Contrast Enhanced

scholarly journals Novel Diagnostic Options without Contrast Media or Radiation: Triggered Angiography Non-Contrast-Enhanced Sequence Magnetic Resonance Imaging in Treating Different Leg Venous Diseases

Diagnostics ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. 355 ◽  
Author(s):  
Chien-Wei Chen ◽  
Yuan-Hsi Tseng ◽  
Chien-Chiao Lin ◽  
Chih-Chen Kao ◽  
Min Yi Wong ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Venous Thrombosis ◽  
Varicose Veins ◽  
Vascular Diseases ◽  
Lower Extremities ◽  
Venous Ulcer ◽  
Resonance Imaging ◽  
Contrast Enhanced ◽  
Venous Diseases

Objectives: Venous diseases in the lower extremities long lacked an objective diagnostic tool prior to the advent of the triggered angiography non-contrast-enhanced (TRANCE) technique. Methods: An observational study with retrospective data analysis. Materials: Between April 2017 and June 2019, 66 patients were evaluated for venous diseases through TRANCE-magnetic resonance imaging (MRI) and were grouped according to whether they had occlusive venous (OV) disease, a static venous ulcer (SU), or symptomatic varicose veins (VV). The clinical appliance of TRANCE-MRI was analysed by groups. Results: In total, 63 patients completed the study. TRANCE-MRI could identify venous thrombosis, including that of the abdominal and pelvic vessels, and it enabled the timely treatment of underlying diseases in patients with OV disease. TRANCE-MRI was statistically compared with the duplex scan, the gold standard to exclude deep vein thrombosis (DVT) in the legs, with regard to their abilities to detect venous thrombosis by using Cohen’s kappa coefficient at a compatible value of 0.711. It could provide the occlusion degree of the peripheral artery for treating an SU. Finally, TRANCE-MRI can be used to outline all collateral veins and occult thrombi before treating symptomatic or recurrent VV to ensure a perfect surgical plan and to avoid complications. Conclusions: TRANCE-MRI is an innovative tool in the treatment of versatile venous pathology in the lower extremities and is widely used for vascular diseases in our institution.

Non-contrast-enhanced magnetic resonance imaging: Objective figures in differentiation between acute and chronic deep venous thrombosis in the lower extremities

2020 ◽  
Vol 35 (10) ◽  
pp. 777-783
Author(s):  
Chih-Chen Kao ◽  
Chien-Wei Chen ◽  
Yuan-Hsi Tseng ◽  
Yuan-Hsiung Tsai ◽  
Shih-Chung Wang ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Deep Vein Thrombosis ◽  
Magnetic Resonance ◽  
Venous Thrombosis ◽  
Lower Extremities ◽  
Interrater Agreement ◽  
Resonance Imaging ◽  
Vein Thrombosis ◽  
Contrast Enhanced ◽  
Deep Vein

Background Deep vein thrombosis is a severe health problem. Treatment options may differ between acute and chronic deep vein thrombosis. Thus, distinguishing acute from chronic deep vein thrombosis is essential for patients with deep vein thrombosis. Triggered angiography non-contrast enhanced is an innovative magnetic resonance imaging protocol that may provide objective evidence in differentiating acute from chronic deep vein thrombosis. Method We prospectively collected information on consecutive patients who had been evaluated through triggered angiography non-contrast enhanced magnetic resonance imaging for venous pathology in their lower extremities at a vascular wound care center in a tertiary hospital between April 2017 and January 2020. Patients included were divided into two groups with the onset time cutoff point of 21 days. All were undergone non-contrast-enhanced magnetic resonance imaging evaluation. Non-contrast-enhanced magnetic resonance imaging images were evaluated by a radiologist, and lower extremity venous thrombosis, collateral-vein development, and subcutaneous honeycombing were emphasized. Cohen’s kappa coefficient was used to measure interrater agreement between the development of collateral veins, subcutaneous honeycombing, and symptom onset over 21 days. Results Interrater agreement analysis revealed that the development of collateral veins was substantially correlated with the onset of symptoms over 21 days (Table 1). Additionally, the development of subcutaneous honeycombing detected through triggered angiography non-contrast enhanced magnetic resonance imaging also substantially agreed with the onset of symptoms over 21 days (Table 2). Conclusion The diagnostic power of triggered angiography non-contrast enhanced magnetic resonance imaging in deep vein thrombosis is rival to current gold standard, color Doppler sonography. Triggered angiography non-contrast enhanced magnetic resonance imaging provides objective information on onset timing in patients with deep vein thrombosis that could differentiate acute from chronic deep vein thrombosis and provides guidance for treatment planning.

Magnetic Resonance Imaging of Deep Venous Thrombosis with Anomalous Inferior Vena Cava

1997 ◽  
Vol 12 (3) ◽  
pp. 115-117
Author(s):  
A. J. Liddicoat ◽  
A. R. Moody ◽  
N. J. M. London
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Inferior Vena Cava ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Inferior Vena ◽  
Vena Cava ◽  
Resonance Imaging ◽  
Anomalous Inferior Vena Cava ◽  
Postoperative Deep Venous Thrombosis

Design: Case report. Setting: Leicester Royal Infirmary. Patients: A 17-year-old male patient presenting with postoperative deep venous thrombosis secondary to anomalous inferior vena cava. Interventions: Imaging to establish the diagnosis, anticoagulation and follow-up. Main outcome measures: Serial magnetic resonance imaging and the clinical condition of the patient were assessed. Results: The patient made a good recovery and did not require a laparotomy. Conclusions: Magnetic resonance imaging is very useful in the detection of central deep venous thrombosis and anomalous inferior vena cava and should be considered in young patients with postoperative deep venous thrombosis.

scholarly journals Evaluation of venous pathology of the lower extremities with triggered angiography non-contrast-enhanced magnetic resonance imaging (TRANCE-MRI)

2019 ◽  
Author(s):  
Yao-Kuang Huang ◽  
Yuan-Hsi Tseng ◽  
Chih-Hung Lin ◽  
Yuan-Hsiung Tsai ◽  
Yin-Chen Hsu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Lower Extremity ◽  
Bypass Graft ◽  
Vena Cava ◽  
Lower Extremities ◽  
Venous Disease ◽  
Common Iliac Vein ◽  
Resonance Imaging ◽  
Contrast Enhanced

Abstract Background: To explore the diagnostic performance of triggered angiography non-contrast-enhanced magnetic resonance imaging (TRANCE-MRI) for the evaluation of venous pathology of the lower extremity. Methods: This was a single-centre prospective cohort study of 25 patients with suspected venous disease in the lower extremities. Each patient received Doppler ultrasonography (for venous evaluation) before the scheduled TRANCE-MRI (for venous and arterial evaluations) on a 1.5T MR scanner (Philips Ingenia, Philips Healthcare, Best, the Netherlands), followed by lymphography and computed tomography angiography that were arranged according to the diagnostic indications. Results: The sensitivity, specificity and accuracy of TRANCE-MRI were 85.7%, 88/9% and 88%, respectively. The inter-rater agreement for deep vein thrombosis (DVT) of the thigh between the ultrasonography and TRANCE-MRI results was substantial agreement (Cohen's kappa κ, 0.72). In ultrasonography-negative cases, TRANCE-MRI detected four additional cases (16%, 4/25) of DVT; three cases (12%, 3/25) of venous compression caused by pelvic lymphadenopathy, hip prosthesis or knee joint effusion; one case (4%, 1/25) of vena cava anomaly; two cases (8%, 2/25) of occult peripheral artery disease (PAD); and one case (4%, 1/25) of an occluded bypass graft. Conclusion : TRANCE-MRI can be used as an alternative and objective tool for assessing lower extremity diseases, especially suspected venous pathology. Compared with ultrasonography, TRANCE-MRI plays a better role in assessing varicose veins of the lower extremities and deep veins of the pelvis and abdomen. However, false-positive results may occur in the left common iliac vein of elderly patients. Finally, occult PAD rarely occurs in patients with suspected lower extremity venous disease. Therefore, we recommend performing the TRANCE-MRV protocol instead of the full protocol (MRV+MRA) in the clinical setting in patients with venous scenarios.

scholarly journals Evaluation of venous pathology of the lower extremities with triggered angiography non-contrast-enhanced magnetic resonance imaging

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yao-Kuang Huang ◽  
Yuan-Hsi Tseng ◽  
Chih-Hung Lin ◽  
Yuan-Hsiung Tsai ◽  
Yin-Chen Hsu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Lower Extremity ◽  
Bypass Graft ◽  
Vena Cava ◽  
Lower Extremities ◽  
Venous Disease ◽  
Common Iliac Vein ◽  
Resonance Imaging ◽  
Contrast Enhanced

Abstract Background To explore the diagnostic performance of triggered angiography non-contrast-enhanced magnetic resonance imaging (TRANCE-MRI) for the evaluation of venous pathology of the lower extremity. Methods This was a single-centre prospective cohort study of 25 patients with suspected venous disease in the lower extremities. Each patient received Doppler ultrasonography (for venous evaluation) before the scheduled TRANCE-MRI (for venous and arterial evaluations) on a 1.5 T MR scanner (Philips Ingenia, Philips Healthcare, Best, the Netherlands), followed by lymphography and computed tomography angiography that were arranged according to the diagnostic indications. Results The sensitivity, specificity and accuracy of TRANCE-MRI were 85.7%, 88/9 and 88%, respectively. The inter-rater agreement for deep vein thrombosis (DVT) of the thigh between the ultrasonography and TRANCE-MRI results was substantial agreement (Cohen’s kappa κ, 0.72). In ultrasonography-negative cases, TRANCE-MRI detected four additional cases (16%, 4/25) of DVT; three cases (12%, 3/25) of venous compression caused by pelvic lymphadenopathy, hip prosthesis or knee joint effusion; one case (4%, 1/25) of vena cava anomaly; two cases (8%, 2/25) of occult peripheral artery disease (PAD); and one case (4%, 1/25) of an occluded bypass graft. Conclusion TRANCE-MRI can be used as an alternative and objective tool for assessing lower extremity diseases, especially suspected venous pathology. Compared with ultrasonography, TRANCE-MRI plays a better role in assessing varicose veins of the lower extremities and deep veins of the pelvis and abdomen. However, false-positive results may occur in the left common iliac vein of elderly patients. Finally, occult PAD rarely occurs in patients with suspected lower extremity venous disease. Therefore, we recommend performing the TRANCE-MRV protocol instead of the full protocol (MRV + MRA) in the clinical setting in patients with venous scenarios.

scholarly journals Evaluation the venous pathology of the lower extremities with triggered angiography non-contrast-enhanced sequence magnetic resonance imaging (TRANCE-MRI)

2019 ◽  
Author(s):  
Yao-Kuang Huang ◽  
Chih-Hung Lin ◽  
Yuan-Hsi Tseng ◽  
Yuan-Hsiung Tsai ◽  
Yin-Chen Hsu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Lower Extremity ◽  
Varicose Veins ◽  
Lower Extremities ◽  
Iliac Vein ◽  
Venous Disease ◽  
Resonance Imaging ◽  
External Compression ◽  
Contrast Enhanced

Abstract Background To explore the diagnostic performance of non-contrast-enhanced magnetic resonance imaging using triggered angiography non-contrast-enhanced sequence (TRANCE-MRI) in evaluation of venous pathology of the lower extremity. Methods This is a single-center prospective cohort study of 25 patients with suspected venous disease in their lower extremities. Each patient received a Doppler ultrasound exam before the scheduled TRANCE-MRI on a 1.5T MR scanner (Philips Ingenia, Philips Healthcare, Best, The Netherlands). The following lymphography and CTA were arranged according to the diagnostic indications. Results The venous scenarios of the 25 patient were divided as follows: 11 had deep venous thrombosis (DVT), seven had a static ulcer, three had symptomatic varicose veins (VV), two had recurrent VV after surgery, and two had lymphedema. TRANCE-MRI unexpectedly found that 4 patients (16%) had occult peripheral arterial occlusive disease. Of the 11 patients with scenario of DVT, 4 patients (36.4%) did not actually have DVT on TRANCE-MRI, and the symptoms were due to malignancy, external compression, and congenital anomalies. One patient (4%) with radiation-related lymphedema was falsely diagnosed as external iliac vein compression. Interrater agreement for DVT in the thigh between the ultrasonography and TRANCE-MRI was substantial agreement (Cohen's kappa κ, 0.72). The sensitivity, specificity and accuracy of TRANCE-MRI were 85.7%, 88/9% and 88%, respectively. Venous thrombi and collateral veins could be clearly outlined by TRANCE-MRI, including in middle femoral veins that might be difficult to detect by ultrasound. Conclusion TRANCE-MRI provided not only vascular image of the lower extremity but also information about the pelvis and abdomen. However, false positive results may occur in iliac vessels. TRANCE-MRI could outline venous thrombi and collateral veins from the abdomen to both calves, and thus, could be a powerful tool in the treatment of venous pathology in the lower extremities.

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