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Clinical Investigations: PULMONARY VASCULATURE |

Three-Dimensional Gadolinium-Enhanced Magnetic Resonance Venography in Suspected Thrombo-occlusive Disease of the Central Chest Veins*

Thomas J. Kroencke, MD; Matthias Taupitz, MD; Renate Arnold, MD; Lutz Fritsche, MD; Bernd Hamm, MD
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*From the Institut für Radiologie, Medizinische Klinik, Universitätsklinikum Charité, Campus Mitte, Humboldt-Universität zu Berlin, Berlin, Germany.

Correspondence to: Thomas J. Kroencke, MD, Institut für Radiologie, Medizinische Klinik, Universitätsklinikum Charité, Campus Mitte, Humboldt-Universität zu Berlin, Schumannstrasse 20/21, 10098 Berlin, Germany; e-mail: Thomas.Kroencke@charite.de



Chest. 2001;120(5):1570-1576. doi:10.1378/chest.120.5.1570
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Study objective: To determine the usefulness of high-resolution three-dimensional (3D) gadolinium-enhanced magnetic resonance venography (MRV) in the evaluation of central venous thrombo-occlusive disease of the chest.

Design: Prospective study.

Setting: University hospital.

Patients: Sixteen consecutive patients with clinically suspected thrombosis of the superior vena cava, subclavian, brachiocephalic/innominate, internal jugular, or axillary veins. Thirteen patients had a neoplasm, two patients had a connective tissue disease, and one patient had a history of strenuous exercise. Twelve of 16 patients had prior central venous catheter placement. MRI was correlated with color-coded duplex sonography (CCDS) in 7 of 16 patients, digital subtraction angiography (DSA) in 3 of 16 patients, and CT in 2 of 16 patients.

Intervention: Contrast-enhanced MRV was performed in a total of 20 examinations. A 3D data set (gradient echo; time to repeat, 4.6 ms; time to echo, 1.8 ms; flip angle, 30°; time of acquisition, 23 s; 512 matrix/64 partitions; slice thickness, 1.5 mm) was acquired in the arterial and venous phase. Overall image quality was assessed on a 5-point scale. The presence, site, and extent of thrombus, as well as presence of an intravascular device, were determined.

Measurements and results: Overall image quality was rated very good (1 point) in 7 of 16 cases (44%) and good (2 points) in 9 of 16 cases (56%). Thrombus was detected in 16 of 16 patients, and complete extent of disease could be determined in 15 of 16 patients (94%). MRV did not miss any finding obtained by CCDS, DSA, or CT, and provided additional information in 6 of 16 examinations (38%).

Conclusion: Contrast-enhanced MRV is a fast and reliable noninvasive procedure with excellent results regarding detection and determination of the extent of thrombo-occlusive disease of the chest veins.

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