Evaluation of venous pathology of the lower extremities with triggered angiography non-contrast-enhanced magnetic resonance imaging
Abstract Background To explore the diagnostic performance of triggered angiography non-contrast-enhanced magnetic resonance imaging (TRANCE-MRI) for the evaluation of venous pathology of the lower extremity. Methods This was a single-centre prospective cohort study of 25 patients with suspected veno...
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doaj-41193b5d18244902b0d001f5dbd559f42020-12-20T12:37:17ZengBMCBMC Medical Imaging1471-23422019-12-011911910.1186/s12880-019-0395-4Evaluation of venous pathology of the lower extremities with triggered angiography non-contrast-enhanced magnetic resonance imagingYao-Kuang Huang0Yuan-Hsi Tseng1Chih-Hung Lin2Yuan-Hsiung Tsai3Yin-Chen Hsu4Shih-Chung Wang5Chien-Wei Chen6Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial HospitalDivision of Thoracic and Cardiovascular Surgery, Chang Gung Memorial HospitalWound Center and Plastic Surgery, Chang Gung Memorial Hospital Chiayi BranchCollege of Medicine, Chang Gung UniversityCollege of Medicine, Chang Gung UniversityCollege of Medicine, Chang Gung UniversityCollege of Medicine, Chang Gung UniversityAbstract Background To explore the diagnostic performance of triggered angiography non-contrast-enhanced magnetic resonance imaging (TRANCE-MRI) for the evaluation of venous pathology of the lower extremity. Methods This was a single-centre prospective cohort study of 25 patients with suspected venous disease in the lower extremities. Each patient received Doppler ultrasonography (for venous evaluation) before the scheduled TRANCE-MRI (for venous and arterial evaluations) on a 1.5 T MR scanner (Philips Ingenia, Philips Healthcare, Best, the Netherlands), followed by lymphography and computed tomography angiography that were arranged according to the diagnostic indications. Results The sensitivity, specificity and accuracy of TRANCE-MRI were 85.7%, 88/9 and 88%, respectively. The inter-rater agreement for deep vein thrombosis (DVT) of the thigh between the ultrasonography and TRANCE-MRI results was substantial agreement (Cohen’s kappa κ, 0.72). In ultrasonography-negative cases, TRANCE-MRI detected four additional cases (16%, 4/25) of DVT; three cases (12%, 3/25) of venous compression caused by pelvic lymphadenopathy, hip prosthesis or knee joint effusion; one case (4%, 1/25) of vena cava anomaly; two cases (8%, 2/25) of occult peripheral artery disease (PAD); and one case (4%, 1/25) of an occluded bypass graft. Conclusion TRANCE-MRI can be used as an alternative and objective tool for assessing lower extremity diseases, especially suspected venous pathology. Compared with ultrasonography, TRANCE-MRI plays a better role in assessing varicose veins of the lower extremities and deep veins of the pelvis and abdomen. However, false-positive results may occur in the left common iliac vein of elderly patients. Finally, occult PAD rarely occurs in patients with suspected lower extremity venous disease. Therefore, we recommend performing the TRANCE-MRV protocol instead of the full protocol (MRV + MRA) in the clinical setting in patients with venous scenarios.https://doi.org/10.1186/s12880-019-0395-4MRINon-contrastVenographyTRANCEStatic ulcerVenous disease |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yao-Kuang Huang Yuan-Hsi Tseng Chih-Hung Lin Yuan-Hsiung Tsai Yin-Chen Hsu Shih-Chung Wang Chien-Wei Chen |
spellingShingle |
Yao-Kuang Huang Yuan-Hsi Tseng Chih-Hung Lin Yuan-Hsiung Tsai Yin-Chen Hsu Shih-Chung Wang Chien-Wei Chen Evaluation of venous pathology of the lower extremities with triggered angiography non-contrast-enhanced magnetic resonance imaging BMC Medical Imaging MRI Non-contrast Venography TRANCE Static ulcer Venous disease |
author_facet |
Yao-Kuang Huang Yuan-Hsi Tseng Chih-Hung Lin Yuan-Hsiung Tsai Yin-Chen Hsu Shih-Chung Wang Chien-Wei Chen |
author_sort |
Yao-Kuang Huang |
title |
Evaluation of venous pathology of the lower extremities with triggered angiography non-contrast-enhanced magnetic resonance imaging |
title_short |
Evaluation of venous pathology of the lower extremities with triggered angiography non-contrast-enhanced magnetic resonance imaging |
title_full |
Evaluation of venous pathology of the lower extremities with triggered angiography non-contrast-enhanced magnetic resonance imaging |
title_fullStr |
Evaluation of venous pathology of the lower extremities with triggered angiography non-contrast-enhanced magnetic resonance imaging |
title_full_unstemmed |
Evaluation of venous pathology of the lower extremities with triggered angiography non-contrast-enhanced magnetic resonance imaging |
title_sort |
evaluation of venous pathology of the lower extremities with triggered angiography non-contrast-enhanced magnetic resonance imaging |
publisher |
BMC |
series |
BMC Medical Imaging |
issn |
1471-2342 |
publishDate |
2019-12-01 |
description |
Abstract Background To explore the diagnostic performance of triggered angiography non-contrast-enhanced magnetic resonance imaging (TRANCE-MRI) for the evaluation of venous pathology of the lower extremity. Methods This was a single-centre prospective cohort study of 25 patients with suspected venous disease in the lower extremities. Each patient received Doppler ultrasonography (for venous evaluation) before the scheduled TRANCE-MRI (for venous and arterial evaluations) on a 1.5 T MR scanner (Philips Ingenia, Philips Healthcare, Best, the Netherlands), followed by lymphography and computed tomography angiography that were arranged according to the diagnostic indications. Results The sensitivity, specificity and accuracy of TRANCE-MRI were 85.7%, 88/9 and 88%, respectively. The inter-rater agreement for deep vein thrombosis (DVT) of the thigh between the ultrasonography and TRANCE-MRI results was substantial agreement (Cohen’s kappa κ, 0.72). In ultrasonography-negative cases, TRANCE-MRI detected four additional cases (16%, 4/25) of DVT; three cases (12%, 3/25) of venous compression caused by pelvic lymphadenopathy, hip prosthesis or knee joint effusion; one case (4%, 1/25) of vena cava anomaly; two cases (8%, 2/25) of occult peripheral artery disease (PAD); and one case (4%, 1/25) of an occluded bypass graft. Conclusion TRANCE-MRI can be used as an alternative and objective tool for assessing lower extremity diseases, especially suspected venous pathology. Compared with ultrasonography, TRANCE-MRI plays a better role in assessing varicose veins of the lower extremities and deep veins of the pelvis and abdomen. However, false-positive results may occur in the left common iliac vein of elderly patients. Finally, occult PAD rarely occurs in patients with suspected lower extremity venous disease. Therefore, we recommend performing the TRANCE-MRV protocol instead of the full protocol (MRV + MRA) in the clinical setting in patients with venous scenarios. |
topic |
MRI Non-contrast Venography TRANCE Static ulcer Venous disease |
url |
https://doi.org/10.1186/s12880-019-0395-4 |
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