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Journal of Cardiovascular Magnetic Resonance

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Open Access 01-12-2017 | Technical notes

Black-blood thrombus imaging (BTI): a contrast-free cardiovascular magnetic resonance approach for the diagnosis of non-acute deep vein thrombosis

Authors: Guoxi Xie, Hanwei Chen, Xueping He, Jianke Liang, Wei Deng, Zhuonan He, Yufeng Ye, Qi Yang, Xiaoming Bi, Xin Liu, Debiao Li, Zhaoyang Fan

Published in: Journal of Cardiovascular Magnetic Resonance | Issue 1/2017

Abstract

Background

Deep vein thrombosis (DVT) is a common but elusive illness that can result in long-term disability or death. Accurate detection of thrombosis and assessment of its size and distribution are critical for treatment decision-making. In the present study, we sought to develop and evaluate a cardiovascular magnetic resonance (CMR) black-blood thrombus imaging (BTI) technique, based on delay alternating with nutation for tailored excitation black-blood preparation and variable flip angle turbo-spin-echo readout, for the diagnosis of non-acute DVT.

Methods

This prospective study was approved by institutional review board and informed consent obtained from all subjects. BTI was first conducted in 11 healthy subjects for parameter optimization and then conducted in 18 non-acute DVT patients to evaluate its diagnostic performance. Two clinically used CMR techniques, contrast-enhanced CMR venography (CE-MRV) and three dimensional magnetization prepared rapid acquisition gradient echo (MPRAGE), were also conducted in all patients for comparison. All images obtained from patients were analyzed on a per-segment basis. Using the consensus diagnosis of CE-MRV as the reference, the sensitivity (SE), specificity (SP), positive and negative predictive values (PPV and NPV), and accuracy (ACC) of BTI and MPRAGE as well as their diagnostic agreement with CE-MRV were calculated. Besides, diagnostic confidence and interreader diagnostic agreement were evaluated for all three techniques.

Results

BTI with optimized parameters effectively nulled the venous blood flow signal and allowed directly visualizing the thrombus within the black-blood lumen. Higher SE (90.4% vs 67.6%), SP (99.0% vs. 97.4%), PPV (95.4% vs. 85.6%), NPV (97.8% vs 92.9%) and ACC (97.4% vs. 91.8%) were obtained by BTI in comparison with MPRAGE. Good diagnostic confidence and excellent diagnostic and interreader agreements were achieved by BTI, which were superior to MPRAGE on detecting the chronic thrombus.

Conclusion

BTI allows direct visualization of non-acute DVT within the dark venous lumen and has the potential to be a reliable diagnostic tool without the use of contrast medium.

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Title: Black-blood thrombus imaging (BTI): a contrast-free cardiovascular magnetic resonance approach for the diagnosis of non-acute deep vein thrombosis
Authors: Guoxi Xie
Hanwei Chen
Xueping He
Jianke Liang
Wei Deng
Zhuonan He
Yufeng Ye
Qi Yang
Xiaoming Bi
Xin Liu
Debiao Li
Zhaoyang Fan
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: Journal of Cardiovascular Magnetic Resonance / Issue 1/2017
Electronic ISSN: 1532-429X
DOI: https://doi.org/10.1186/s12968-016-0320-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Black-blood thrombus imaging (BTI): a contrast-free cardiovascular magnetic resonance approach for the diagnosis of non-acute deep vein thrombosis

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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