Usefulness of non-contrast-enhanced magnetic resonance imaging prior to venous interventions

Abstract

Introduction: The number of venous interventions continues to rise. The outcome of venous procedures is related to appropriate stent selection and implantation. Aim: To compare the usefulness of magnetic resonance imaging (MRI) and intravascular ultrasound (IVUS) in the determination of target vein section area (VSA) as techniques for selecting an appropriate diameter for a venous stent. Material and methods: VSAs of iliac and common femoral veins obtained in contrast-enhanced MRI (CE-MRI) and non-contrast-enhanced MRI (NCE-MRI) were calculated for 18 consecutive patients with post-thrombotic syndrome (PTS), and VSAs obtained using IVUS were calculated for 15 of these PTS patients. Results: The differences in iliac and common femoral vein VSAs obtained using CE-MRI and NCE-MRI were small and not clinically significant. VSAs of vessels obtained using CE-MRI and NCE-MRI correlated significantly with each other, with R values in the range 0.87-0.97 and p-values < 0.001. However, no significant relationships were found between section areas measured using MRI and IVUS and the differences in measurements was, on average, to 60%. Conclusions: CE magnetic resonance venography can be replaced by Dixon-based NCE-MRI in the preoperative evaluation of patients with PTS who qualify for venous intervention. However, CE-MRI and NCE-MRI performed for ipsilateral and contralateral extremities are not sufficient for appropriate venous stent selection, and IVUS remains a necessary tool in determining venous intervention in iliac veins.