Usefulness of triggered non-contrast-enhanced magnetic resonance angiography in assessing lower extremity venous disease

doi:10.1097/MD.0000000000025809

中山醫學大學機構典藏 CSMUIR > 中山醫學大學研究成果 > 期刊論文 > Item 310902500/23868

Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/23868

Title:	Usefulness of triggered non-contrast-enhanced magnetic resonance angiography in assessing lower extremity venous disease
Authors:	Chen, CW;Ting, H;Chen, PY;Weng, JC;Hsu, YC;Wang, SC;Tseng, YH;Huang, YK
Keywords:	deep vein thrombosis;lower extremity;magnetic resonance imaging;non-contrast-enhanced;triggered angiography non-contrast-enhanced;venous disease
Date:	2021
Issue Date:	2022-08-05T09:44:10Z (UTC)
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
ISSN:	0025-7974
Abstract:	Although venous duplex ultrasonography (USG) is reliable for diagnosing lower extremity venous disease (LEVD), cross-sectional imaging studies were usually required before intervention or surgery. Patients of LEVD with renal insufficiency usually restrict the use of contrast-enhanced imaging modalities. In seeking an alternative imaging solution for these patients, we explore the clinical utility of triggered angiography non-contrast-enhanced magnetic resonance imaging (TRANCE-MRI) in the assessment of LEVD. We collected data from patients presenting to a tertiary wound-care center with symptoms of LEVD from April 2017-November 2019. Each participant underwent baseline USG followed by TRANCE-MRI on a 1.5T MR scanner (Philips Ingenia, Philips Healthcare, Best, The Netherlands). Inter-rater reliability was measured using Cohen's kappa (kappa). All 80 participants (mean age, 61.9 +/- 14.8 years; 35 males, 45 females) were assessed and were classified into one of five disease groups, deep vein thrombosis (n = 38), venous static ulcer (n = 16), symptomatic varicose veins (n = 18), recurrent varicose veins (n = 3), and lymphoedema (n = 5). The inter-rater reliability between TRANCE-MRI and doppler USG showed substantial agreement (kappa, 0.73). The sensitivity, specificity, and accuracy of TRANCE-MRI were 90.5%, 88.1%, and 88.8%, respectively. In 59 (73.8%) USG-negative patients, we were able to diagnose positive findings (deep venous thrombosis, n = 7; varicose veins, n = 15; lymphedema, n = 10; iliac vein compression with thrombosis, n = 6; external venous compression, n = 5; vena cava anomaly, n = 2; occult peripheral artery disease, n = 5; ccluded bypass graft, n = 1) by using TRANCE-MRI. Of these, 9 (15.3%) patients underwent additional vascular surgery based on positive TRANCE-MRI findings. TRANCE technique provides the limb's entire venous drainage in clear images without background contamination by associated arterial imaging. Additionally, simultaneous evaluation of bilateral lower extremities can help determine the lesion's exact site. Although TRANCE-MRI can provide MR arteriography and MR venography, we recommend performing only MR venography in symptomatic LEVD patients because the incidence of occult arterial disease is low.
URI:	http://dx.doi.org/10.1097/MD.0000000000025809 https://www.webofscience.com/wos/woscc/full-record/WOS:000658953300025 https://ir.csmu.edu.tw:8080/handle/310902500/23868
Relation:	MEDICINE ,2021,v100,issue 20
Appears in Collections:	[中山醫學大學研究成果] 期刊論文

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