MR Imaging in Venous Thromboembolism

  • H. D. Sostman


Effective therapy is available for venous thromboembolism, but can itself produce significant morbidity. Thus, an accurate diagnosis is mandatory. The clinical presentation and laboratory findings in pulmonary embolism (PE) are nonspecific; therefore, additional evaluation with imaging studies is essential. However, the most accurate imaging test (pulmonary angiography) is invasive, while noninvasive imaging tests (such as the ventilation-perfusion [V-Q] scan) have limited accuracy. Accordingly, there have been persistent attempts to develop a less invasive, more accurate imaging procedure which could replace either the V-Q scan or the pulmonary angiogram. In addition, the use of noninvasive lower extremity venous imaging to evaluate patients who present with respiratory symptoms has become widespread.


Pulmonary Embolism Deep Venous Thrombosis Pulmonary Angiography Pulmonary Angiogram Peripheral Pulmonary Artery 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Hull RD, Hirsch J et al (1983) Pulmonary angiography, ventilation lung scanning and venography for chnically suspected pulmonary embolism with abnormal perfusion lung scan. Ann Intern Med 98:891–899PubMedGoogle Scholar
  2. 2.
    Dorfman GS, Cronan JJ, Tupper TB et al (1987) Occult pulmonary embolism: a common occurrence in deep venous thrombosis. AJR 148:263–266PubMedGoogle Scholar
  3. 3.
    Hull R, Hirsh J, Sackett DL et al (1981) Clinical vahdity of a negative venogram in patients with clinically suspected venous thrombosis. Circulation 64:622–625PubMedCrossRefGoogle Scholar
  4. 4.
    Redman HC (1988) Deep venous thrombosis: is contrast venography still the diagnostic “gold standard”? Radiology 168:277–278PubMedGoogle Scholar
  5. 5.
    Bettmann MA, Robbins A, Braun SD, Wetzner S, Dunnick NR, Finkelstein J (1987) Contrast venography of the leg: diagnostic efficacy, tolerance and compHcation rates with ionic and nonionic contrast media. Radiology 165:113–116PubMedGoogle Scholar
  6. 6.
    Lensing AWA, Prandoni P, Buller HR, Casara D, Cogo A, Wouter ten Cate J (1990) Lower extremity venography with iohexol: results and complications. Radiology 177:503–505PubMedGoogle Scholar
  7. 7.
    Lensing AWA, Prandoni P, Brandjes D et al (1989) Detection of deep-vein thrombosis by realtime B-mode ultrasonography. N Engl J Med 320:342–345PubMedCrossRefGoogle Scholar
  8. 8.
    Vaccaro JP, Cronan JC, Dorfman GS (1990) Outcome analysis of patients with normal compression US examinations. Radiology 175:645–649PubMedGoogle Scholar
  9. 9.
    Yucel EK, Fisher JS, Egglin TK, Geller SC, Waltman AC (1991) Isolated calf venous thrombosis: diagnosis with compression US. Radiology 179:443–446PubMedGoogle Scholar
  10. 10.
    Murphy TP, Cronan JJ (1990) Evolution of deep venous thrombosis: a prospective evaluation with US. Radiology 177:543–548PubMedGoogle Scholar
  11. 11.
    Cronan JJ, Leen V (1989). Recurrent deep venous thrombosis: Hmitations of US. Radiology 170:739–742PubMedGoogle Scholar
  12. 12.
    Murphy TP, Cronan JJ (1990) Evolution of deep venous thrombosis: a prospective evaluation with US. Radiology 77:543–548Google Scholar
  13. 13.
    Ginsberg JS, Caco CC, Brill-Edwards PA et al (1991) Venous thrombosis in patients who have undergone major hip or knee surgery: detection with compression US and impedance plethysmography. Radiology 181:651–654PubMedGoogle Scholar
  14. 14.
    Khaitan L, Midgette AS, Taylor CL, Zwolak RM, Stukel TA (1993) A meta-analysis of the use of color flow Doppler ultrasound in assessing proximal deep vein thrombosis in symptomatic compared to asymptomatic high-risk patients. Presented at the 15th Annual Meeting, Society for Medical Decision Making, Research Triangle, NCGoogle Scholar
  15. 15.
    Spritzer CE, Sostman HD, Wilkes DC, Coleman RE (1990) Deep venous thrombosis: experience with gradient-echo MR imaging in 66 patients. Radiology 177:235–241PubMedGoogle Scholar
  16. 16.
    Erdman WA, Jay son HT, Redman HC, Miller GL, Parkey RW, Peshock RW (1990) Deep venous thrombosis of the extremities role of MR imaging in the diagnosis. Radiology 174: 425–431PubMedGoogle Scholar
  17. 17.
    Vukov LF, Berquist TH, King BF (1991) Magnetic resonance imaging for calf deep venous thrombosis. Ann Emerg Med 20:497–499PubMedCrossRefGoogle Scholar
  18. 18.
    Evans AJ, Sostman HD, Knelson MH, Spritzer CE, Newman GE, Paine SS, Beam CA (1993) Detection of deep venous thrombosis: prospective comparison of MR imaging with contrast venography. AJR 161:131–139PubMedGoogle Scholar
  19. 19.
    Hansen ME, Spritzer CE, Sostman HD (1990) Assessing the patency of mediastinal and thoracic inlet veins: value of MR imaging. AJR 155:1177–1182PubMedGoogle Scholar
  20. 20.
    Knight LC (1993) Scintigraphic methods for detecting vascular thrombus. J Nucl Med 34: 554–561PubMedGoogle Scholar
  21. 21.
    Remy-Jardin M, Remy J, Wattine L, Giraud F (1992) Central pulmonary thromboembolism: diagnosis with spiral volumetric CT with the single-breath-hold technique — comparison with pulmonary angiography. Radiology 185:381–387PubMedGoogle Scholar
  22. 22.
    Chintapolli K, Thorsen MK, Olsen DL, Goodman LR, Gurney J (1988) Computed tomography of pulmonry thromboembolism and infarction. J Comput Assist Tomogr 2: 553–559CrossRefGoogle Scholar
  23. 23.
    Rossum AV, Kieft G, Treumiet F, Schepers-Bok R, Smith S (1994) Spiral volumetric CT in patients with clinical suspicion of pulmonary embohsm. Radiology 193(P):262 (abstr)Google Scholar
  24. 24.
    Goodman LR, Curtin JJ, Foley WD, Lipchik RJ, Mewissen MW, Sagar KB (1994) Helical CT of patients with “unresolved suspicion” of pulmonary embohsm. Radiology 19(P):262 (abstr)Google Scholar
  25. 25.
    Stanford W, Reiners TJ, Thompson BH, Landas SK, Galvin JR (1994) Contrast-enhanced thin slice ultrafast computed tomography for the detection of small pulmonary emboli. Invest Radiol 29:184–187PubMedCrossRefGoogle Scholar
  26. 26.
    Teigen CL, Maus TP, Sheedy PF, Johnson TM, Stanson AW, Welch TJ (1993) Pulmonary embohsm: diagnosis with electron-beam CT. Radiology 188:839–845PubMedGoogle Scholar
  27. 27.
    Grist TM, Sostman HD, MacFall JR, Foo TKF, Spritzer CE, Witty L, Newman GE, Debatin JF, Tapson V, Saltzman HA (1993) Pulmonary angiography using MRI: initial clinical experience. Radiology 189:528–530Google Scholar
  28. 28.
    Schiebler ML, Holland GA, Hatabu H, Listerud J, Foo T, Palevsky H, Edmunds H, Gefter WB (1993) Suspected pulmonary embolism: prospective evaluation with pulmonary MR angiography. Radiology 189:125–131PubMedGoogle Scholar
  29. 29.
    Erdman WA, Peshock RM, Redman HC et al (1994) Pulmonary embohsm: comparison of MR images with radionuclide and angiographic studies. Radiology 190:499–508PubMedGoogle Scholar
  30. 30.
    Porter TR, Mohanty PK, Pandian NG (1994) Intravascular ultrasound imaging of pulmonary arteries. Chest 106:1551–1557PubMedCrossRefGoogle Scholar
  31. 31.
    Woodard PK, Sostman HD, MacFall JR et al (1995) Detection of pulmonary embolism: comparison of contrast-enhanced spiral CT and time-of-flight MR techniques. J Thorac Imaging 10:59–72PubMedCrossRefGoogle Scholar
  32. 32.
    The PIOPED Investigators (1990) Value of the ventilation/perfusion scan in acute pulmonary embohsm. JAMA 263:2753–2759CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia, Milano 1996

Authors and Affiliations

  • H. D. Sostman

There are no affiliations available

Personalised recommendations