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.
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.
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.
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