Magnetic Resonance Vessel Wall Imaging In The Diagnosis Of DVT: A Preliminary Clinical Study

ObjectiveThe objective of this study was to evaluate the clinical feasibility of a novel T1 Weighted Delay Alternating with Nutation for Tailored Excitation and variable-flip-angle turbo spin-echo(T1W DANTE-SPACE)3-dimensional non contrast enhanced magnetic resonance venography vessel wall imaging (3D NCE-MRV) technique for the diagnosis of deep vein thrombosis (DVT) in comparison with CE venography (CE-MRV).MethodsForty patients (22males,35-83 years) with proven DVT in duplex ultrasound (n=37) or with pulmonary embolism in Computed Tomography Angiography (CTA) and suspected to have DVT (n= 3) were consecutively imaged with NCE-MRV and CE-MRV. Sensitivity (SE), specificity (SP), positive and negative predictive values (PPV and NPV, respectively), Cohen κ, as well as accuracy of NCE-MRV for the diagnosis of were calculated and compared with CE-MRV and as a standard of reference. Image quality and diagnostic confidence were assessed on a 4-point scale. All raw data were statistically analyzed using SPSS 22.0 software.ResultsImage quality and diagnostic confidence level of pre-and post-vessel wall MR imaging were comparable (|Z|=1.342, P=0.180 and|Z|=1.604, P=0.109; both P values are nonsignificant). Using CE-MRV as the criterion standard, there was a high agreement between the CE-MRV and the NCE vessel wall MRI examinations for the detection of DVT, with κ of 0.89 for doctor A and κ of 0.88 for doctor B (both P< 0.001, significant). The SE, SP, PPV, NPV, as well as accuracy of NCE vessel wall MRI were 89.5%,98.6%,92.9%,97.9%, and97.1% for doctor A as well as 89.2%,98.3%,91.2%,97.9%, and 96.9% for doctor B.ConclusionT1W DANTE-SPACE vessel wall MR imaging can be used to diagnose DVT with excellent agreement compared with CE-MRV. It has great potential in the accurate diagnosis of lower limbs DVT, thus providing a reliable basis for clinical treatment of DVT.