Simultaneous MR Arteriography and Venography With Blood Pool Contrast Agent Detects Deep Venous Thrombosis in Suspected Arterial Disease
Simultaneous MR Arteriography and Venography With Blood Pool Contrast Agent Detects Deep Venous Thrombosis in Suspected Arterial Disease
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DOI：
10.2214/ajr.11.7306
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发表时间：
2012-05-01
影响因子：
5
通讯作者：
Willinek, Winfried A.
中科院分区：
文献类型：
--
作者：
Hadizadeh, Dariusch R.;Kukuk, Guido M.;Willinek, Winfried A.
OBJECTIVE.本研究的目的是调查临床怀疑外周动脉闭塞性疾病（PAOD）患者中偶然发生深静脉血栓（DVT）的患病率，使用对比增强磁共振血管造影（MRA）与血池造影剂。对245名连续患者（161名男性;年龄范围，36-92岁）的259次血池造影剂MRA检查，共产生4102个可评估的动脉和静脉血管节段，评估了偶然观察到的急性和机化DVT的发生率和动脉狭窄等级。使用多普勒超声证实了偶发DVT。外侧非病变静脉作为内部对照。采用卡方检验和Mann-Whitney U检验研究PAOD分期与急性和机化DVT之间的关系。使用血池造影剂进行MRA的动脉狭窄分级显示，78%的节段（3199/4102）管腔狭窄小于50%，8%的节段（317/4102）狭窄≥ 50%，14%的节段（586/4102）闭塞。245例患者中有26例（11%）观察到偶发DVT（10例患者和26个节段观察到急性DVT; 17例患者和35个节段观察到机化DVT; 1例患者同时患有急性和机化DVT）。所有偶然诊断的DVT病例均经双功超声证实。内部对照未发现假阳性或假阴性结果（26例患者和172个节段）。在动脉狭窄不超过50%的患者中，意外急性DVT明显更常见（p < 0.05）。另外，方丹PAOD分期与急性DVT（p = 0.688）或机化DVT（p = 0.995）的发生之间无显著相关性。在临床疑似PAOD的患者中，11%的患者发生了偶发性DVT。使用血池造影剂的MRA在同时评估动脉和静脉中具有潜在作用，并且可以检测影响治疗管理的伴随静脉疾病。
OBJECTIVE. The purpose of this study was to investigate the prevalence of incidental deep venous thrombosis (DVT) in patients with clinically suspected peripheral arterial occlusive disease (PAOD) using contrast-enhanced MR angiography (MRA) with a blood pool contrast agent.SUBJECTS AND METHODS. Two hundred fifty-nine MRA examinations with blood pool contrast agent in 245 consecutive patients (161 men; age range, 36-92 years), yielding a total of 4102 assessable arterial and venous vessel segments, were assessed with regard to the rate of incidentally observed acute and organized DVT and arterial stenosis grades. Incidental DVT was confirmed using duplex ultrasound. Contralateral nondiseased veins served as internal controls. The relationship between PAOD stages and acute and organized DVT was investigated using chi-square tests and a Mann-Whitney U test.RESULTS. Arterial stenosis grading using MRA with blood pool contrast agent revealed less than 50% luminal stenosis in 78% of segments (3199/4102), 50% or greater stenosis in 8% of segments (317/4102), and occlusion in 14% of segments (586/4102). Incidental DVT was observed in 26 of 245 patients (11%) (acute DVT was seen in 10 patients and 26 segments; organized DVT was seen in 17 patients and 35 segments; and one patient had both acute and organized DVT). All incidentally diagnosed cases of DVT were confirmed by duplex ultrasound. Internal controls revealed no false-positive or -negative findings (26 patients and 172 segments). Incidental acute DVT was significantly more common among patients without arterial stenosis greater than 50% (p < 0.05). Otherwise, there was no significant relationship between Fontaine PAOD stages and the occurrence of acute (p = 0.688) or organized (p = 0.995) DVT.CONCLUSION. Incidental DVT was prevalent in 11% of patients with clinically suspected PAOD. MRA with blood pool contrast agent has a potential role in the simultaneous assessment of arteries and veins and can detect concomitant venous disease affecting therapeutic management.