Pelvic and lower extremity veins: Contrast-enhanced three-dimensional MR venography with a dedicated vascular coil-initial experience

PURPOSE: To assess the performance of three-dimensional (3D) magnetic reson ance (MR) venography of the pelvis and lower extremities in patients withou t acute deep venous thrombosis by using a lower extremity vascular coil and pedal injection of paramagnetic contrast material. MATERIALS AND METHODS: Conventional and MR venography were performed in 35 legs in 25 patients referred for evaluation of varicosities (n = 8) and pos tthrombotic changes (n = 7) and assessment of the great saphenous veins pri or to bypass surgery (n = 10). Injection of 120 mL of diluted (1:15) gadope ntetate dimeglumine into a pedal vein was performed manually at a rate of 1 mL/sec, and 3D gradient-recalled echo data sets of the upper and lower vei ns were collected. Conventional and MR venographic images were analyzed sep arately in a blinded fashion. RESULTS: MR image quality was comparable to that of conventional venograms. Varicose changes of the great and small saphenous Veins (sensitivity, 94% [44 of 47]; specificity, 96% [89 of 93]) were assessed as reliably as their status before bypass surgery:(sensitivity, 98% [53 of 54]; specificity, 92 % [47 of 51]). Postthrombotic change!; were diagnosed with a sensitivity of 100% [13 of 13] and a specificity of 98% [88 of 90]. CONCLUSION: Direct 3D MR venography comprehensively displays the lower extr emity venous system and permits assessment of postthrombotic and varicose c hanger; and the bypass suitability of the saphenous vein.