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Pelvic and Lower Extremity Veins: Contrast-enhanced Three-dimensional MR Venography with a Dedicated Vascular Coil-Initial Experience¹

¹ From the Institute of Diagnostic Radiology, University Hospital Zurich, Switzerland. From the 1998 RSNA scientific assembly. Received April 30, 1999; revision requested June 16; revision received August 2; accepted August 12. Address correspondence to J.F.D., Department of Diagnostic Radiology, University Hospital Essen, Hufelandstrasse 55, D-45122 Essen, Germany (e-mail: debatin@uni-essen.de).

PURPOSE: To assess the performance of three-dimensional (3D) magnetic resonance (MR) venography of the pelvis and lower extremities in patients without 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 postthrombotic changes (n = 7) and assessment of the great saphenous veins prior to bypass surgery (n = 10). Injection of 120 mL of diluted (1:15) gadopentetate 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 veins were collected. Conventional and MR venographic images were analyzed separately 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 changes 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 extremity venous system and permits assessment of postthrombotic and varicose changes and the bypass suitability of the saphenous vein.

Index terms: Extremities, MR, 44.121412, 44.12142, 45.121412, 45.12142, 46.121412, 46.12142 • Magnetic resonance (MR), comparative studies, 93.124, 93.129412, 93.12942 • Magnetic resonance (MR), vascular studies, 93.129412, 93.12942 • Veins, abnormalities, 93.751, 93.753 • Veins, extremities, 93.751, 93.753, 93.91 • Veins, MR, 93.129412, 93.12942 • Venography, 93.124

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