Direct abdominal vein thrombus imaging (DATI): a contrast-free black-blood MR technique for the diagnosis of abdominal vein thrombosis

• Published in: Abdominal imaging 2024-09, Vol.49 (9), p.3274-3281
• Main Authors: Liao, Liping, Chen, Jiayuan, Liu, Zeping, Liang, Shengyuan, Qin, Lei, Lin, Xinmei, Pan, Shengzhang, Tan, Mingxia, Huang, Lanbin, Ruan, Qizeng, Huang, Zehe, Shi, Caiyun, Xie, Guoxi
• Format: Article
• Language: English
• Subjects: Abdomen; Abdomen - blood supply; Abdomen - diagnostic imaging; Adult; Aged; Blood; Blood clots; Computed tomography; Contrast agents; Contrast Media; Diagnosis; Diagnostic systems; Female; Gastroenterology; Hepatology; Humans; Image contrast; Image enhancement; Image quality; Imaging; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medical diagnosis; Medical imaging; Medicine; Medicine & Public Health; Middle Aged; Phlebography - methods; Prospective Studies; Radiology; Sensitivity and Specificity; Signal quality; Technical; Thrombosis; Veins; Veins & arteries; Venous Thrombosis - diagnostic imaging
• ISSN: 2366-0058; 2366-004X; 2366-0058
• DOI: 10.1007/s00261-024-04335-3

Objectives To develop and evaluate a direct abdominal vein thrombus imaging (DATI) technique, based on a respiratory navigating SPACE sequence with DANTE black-blood preparation, for diagnosing abdominal vein thrombosis (AVT) without the use of exogenous contrast agents. Methods We prospectively enrolled 10 healthy subjects and 28 suspected AVT patients who underwent DATI scans on 3.0 T MRI. Contrast-enhanced CT venography (CTV) was also conducted on the suspected AVT patients for comparison. All images were analyzed by two blinded radiologists who independently evaluated randomized images and gave image quality and diagnostic confidence scores (1-poor, 4-excellent) for DATI and CTV. The accuracy (ACC), sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) of CTV were calculated using CTV as a standard reference. The diagnostic agreement between DATI and CTV as well as the interobserver agreement were conducted using Cohen κ test. Results The patient study demonstrated that DATI can provide adequate thrombus signal intensity and the contrast between the thrombus to dark venous lumen for the diagnosis of AVT. It offers good to excellent image quality (reader1/reader2: 3.50 ± 0.64/3.42 ± 0.63, κ = 0.872) and diagnostic confidence (reader1/reader2: 3.71 ± 0.53/3.78 ± 0.42, κ = 0.804) for the diagnosis of AVT. Taking CTV as a reference, DATI has high accuracy (96.6%), SE (91.5%), SP (98.0%), PPV (92.3%), and NPV (97.8%). Data conclusion DATI can provide good to excellent image quality, effective venous blood signal suppression, and definitive thrombus detection for the diagnosis of AVT without the use of exogenous contrast agents.