Pg. Larcom et al., MAGNETIC-RESONANCE VENOGRAPHY VERSUS CONTRAST VENOGRAPHY TO DIAGNOSE THROMBOSIS AFTER JOINT SURGERY, Clinical orthopaedics and related research, (331), 1996, pp. 209-215
Magnetic resonance venography is a recently developed, noninvasive mea
ns of visualizing the proximal veins of the lower extremity and pelvis
, Magnetic resonance venography is compared with standard contrast ven
ography in the diagnosis of proximal deep vein thrombosis after total
joint arthroplasty. Two hundred seven extremities were evaluated in a
blinded study 5 to 7 days after surgery, Standard contrast venography
identified 11 proximal deep vein thromboses, Initial interpretations o
f the magnetic resonance venographies by staff radiologists identified
5 of the proximal vein thromboses (sensitivity 45%), Two patients wit
h negative standard contrast venographies were identified as positive
(specificity 99%), A retrospective review of all magnetic resonance ve
nographies by a dedicated magnetic resonance angiographer identified 1
0 of 11 deep vein thromboses seen on standard contrast venography (sen
sitivity 91%), Both false negatives were identified as positives. Stan
dard contrast venography remains the gold standard for identifying pro
ximal vein thromboses, Emerging magnetic resonance imaging techniques
have created a potential alternative modality by which to identify dee
p vein thrombosis, The present study suggests that standard contrast v
enography continues to be the most accurate modality currently availab
le, Although magnetic resonance venography seems to be accurate, its i
nterpretation requires experience. As costs diminish and experience in
creases, magnetic resonance venography will have increased importance
in the clinical recognition of deep vein thrombosis.