ANGIOMAGNETIC RESONANCE IMAGING OF ILIOFEMOROCAVAL VENOUS THROMBOSIS

Although magnetic resonance imaging has been proposed for the diagnosi s of deep venous thrombosis (DVT), its role in diagnostic strategy rem ains to be defined. We compared prospectively magnetic resonance angio graphy (MRA) with two-dimensional time-of-flight with contrast venogra phy (CV) and colour duplex sonography (CDS) in 25 patients with DVT of the pelvis confirmed by CV. All patients were examined by CV (gold st andard) and MRA and 17 by CDS. These studies were compared for DVT dia gnosis in the pelvis and inferior vena cava and analysis of thrombotic spread. MRA was positive in 25 patients whose DVT was diagnosed by CV (100% sensitivity). MRA sensitivity and negative predictive value wer e 100%, specificity 98.5% and positive predictive value 97.5% for the diagnosis of thrombosis at each anatomic level. There were discrepanci es between MRA and CV (2 false-positive results for 2 venous segments) and between CDS and CV (2 false-positive and 3 false-negative results ). CV was uninterpretable for 8.8% of segments and CDS was often techn ically limited to the pelvic level, whereas all venous segments explor ed were analysable in MRA. MRA gave excellent results for positive dia gnosis and DVT spread. MRA is a potentially valuable technique for ass essing iliofemorocaval venous thrombosis.