DETECTION OF DEEP VENOUS THROMBOSIS - PROSPECTIVE COMPARISON OF MR-IMAGING WITH CONTRAST VENOGRAPHY

OBJECTIVE. Preliminary reports have described the use of MR imaging fo r the detection of deep venous thrombosis. However, no prospective stu dy comparing MR imaging with contrast venography (the gold standard) h as been reported. Accordingly, we performed a prospective, blinded stu dy of the efficacy of MR imaging in 61 consecutive patients with clini cally suspected deep venous thrombosis. In cases of disagreement, addi tional testing was performed to determine the diagnosis. SUBJECTS AND METHODS. From June 1991 to February 1992, 61 patients with clinically suspected deep venous thrombosis were examined with venography and MR imaging. The average time between studies was 3 hr. In 21 of the 61 pa tients, the final diagnosis was deep venous thrombosis. RESULTS. For d etection of deep venous thrombosis in the pelvis, the sensitivity of M R imaging was 100% (9/9) with a 95% confidence interval of 72-100% and the specificity was 95% (52/55) with a 95% confidence interval of 85- 99%. In the thigh, the sensitivity (16/16) and specificity (43/43) wer e both 100% with 95% confidence intervals of 83-100% and 93-100%, resp ectively. In the calf, the sensitivity was 87% (13/15) with a 95% conf idence interval of 60-98% and the specificity was 97% (36/37) with a 9 5% confidence interval of 86-100%. CONCLUSION. We found no statistical ly significant difference between MR imaging and contrast venography i n the detection of deep venous thrombosis. This result suggests that M R imaging is at least as sensitive and specific as contrast venography in the detection of deep venous thrombosis.