Contrast-free MR phlebography as a method of screening of phlebothromboses and extravasal compression of the inferior vena cava and its basin

Shebryakov V.V.^1,2, Karmazanovsky G.G.¹, StoikoYu.M.², Mazaishvili K.V.², Lyutarevich D.K.¹, Kim S.Yu.¹, Feldsherov M.V.¹, Yashkin M.N.²

1) Medical Diagnostic Centre "Ramsey Diagnostics",
2) National Medical Surgical Centre named after N.I. Pirogov, Moscow, Russia

The study was aimed at assessing possibilities and determining diagnostic significance of the method of contrast-free magnetic resonance phlebography (MR phlebography) in diagnosis of diseases of the inferior vena cava (IVC) and its basin. Presented herein is experience with examining a total of 74 patients at two therapeutic-diagnostic facilities: the National Medical Surgical Centre named after N.I. Pirogov and the Medical Diagnostic Centre "Ramsey Diagnostics". The studies were carried out on magnetic resonance tomographs "Philips Intera Nova" and "GE Optima MR360", using a special protocol of contrast-free MR-phlebography in consequences at free breathing, followed by 3D reconstruction and processing of the obtained images as MIP and 3D. According to the obtained results our method makes it possible to visualize the anatomical passage of the vessels of the IVC basin, interrelationship with adjoining structures and osseous elements, to determine localization of the thrombus, its length, diameter of the vessel and degree of its narrowing at the level of the lesion, as well as to assess the collateral outflow without contrast enhancement. The sensitivity of the method in thromboses of the IVC basin veins amounted to 92%, with the specificity amounting to 90%. Hence, contrast-free MR phlebography is the most optimal screening method requiring no contrast medium, short in time and absolutely safe procedure in diagnosing the causes of extra- and intravasal pathology of the IVC and its basin as compared with ultrasonographic examination, contrast-enhanced phlebography, computed tomography (CT) and contrast-enhanced magnetic resonance tomography.

KEY WORDS: inferior vena cava, venous thrombosis, MR phlebography.

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