Differentiation of deep venous thrombosis from femoral vein mixing artifact on routine abdominopelvic CT.
Abdom Imaging
; 40(8): 3191-5, 2015 Oct.
Article
em En
| MEDLINE
| ID: mdl-26296540
ABSTRACT
PURPOSE:
The objective of this study is to assess the performance of qualitative and quantitative imaging features for the differentiation of deep venous thrombosis (DVT) from mixing artifact on routine portal venous phase abdominopelvic CT.METHODS:
This retrospective study included 40 adult patients with a femoral vein filling defect on portal venous phase CT and a Duplex ultrasound (n = 36) or catheter venogram (n = 4) to confirm presence or absence of DVT. Two radiologists (R1, R2) assessed the femoral veins for various qualitative and quantitative features.RESULTS:
60% of patients were confirmed to have DVT and 40% had mixing artifact. Features with significantly greater frequency in DVT than mixing artifact (all p ≤ 0.006) were central location (R1 90% vs. 28%; R2 96% vs. 31%), sharp margin (R1 83% vs. 28%; R2 96% vs. 31%), venous expansion (R1 48% vs. 6%, R2 56% vs. 6%), and venous wall enhancement (R1 62% vs. 0%; R2 48% vs. 0%). DVT exhibited significantly lower mean attenuation than mixing artifact (R1 42.1 ± 20.2 vs. 57.1 ± 23.6 HU; R2 43.6 ± 19.4 vs. 58.8 ± 23.4 HU, p ≤ 0.031) and a significantly larger difference in vein diameter compared to the contralateral vein (R1 0.4 ± 0.4 vs. 0.1 ± 0.2 cm; R2 0.3 ± 0.4 vs. 0.0 ± 0.1 cm, p ≤ 0.026). At multivariable analysis, central location and sharp margin were significant independent predictors of DVT for both readers (p ≤ 0.013).CONCLUSION:
Awareness of these qualitative and quantitative imaging features may improve radiologists' confidence for differentiating femoral vein DVT and mixing artifact on routine portal venous phase CT. However, given overlap with mixing artifact, larger studies remain warranted.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Tomografia Computadorizada por Raios X
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Artefatos
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Trombose Venosa
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Veia Femoral
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Qualitative_research
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Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article