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Erschienen in: Skeletal Radiology 10/2019

26.04.2019 | Scientific Article

Characterization of intramuscular calf vein thrombosis on routine knee MRI

verfasst von: David P. Duncan, Michael Taddonio, Eric Y. Chang, Brady K. Huang

Erschienen in: Skeletal Radiology | Ausgabe 10/2019

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Abstract

Objective

Literature regarding intramuscular calf vein thrombosis (IMCVT) or infrapopliteal deep vein thrombosis (DVT) evaluation by magnetic resonance imaging (MRI) is limited, particularly with regard to routine unenhanced knee examinations. We attempt to correlate routine unenhanced MRI findings with ultrasound evaluations of the lower extremity deep venous system.

Materials and methods

The radiology information system was searched, yielding a total of 67 patients who had undergone both routine knee MRI and duplex ultrasound examinations within 14 days. The MRI examination findings recorded were the presence and pattern of edema, segmental vein dilation, intraluminal signal on fluid-sensitive sequences, and abnormal hyperintense signal on axial T1-weighted sequences. The presence and extent of thrombus more centrally (i.e., intramuscular calf vein thrombosis with or without extension into the popliteal vein) was reassessed on ultrasound.

Results

When comparing patients with positive (n = 13) and negative (n = 54) ultrasound, there were significant differences in each of these parameters: perivascular edema, intramuscular edema, focal vein dilation, and abnormal fluid-sensitive signal. In the subset of patients with popliteal extension of the intramuscular calf vein thrombosis compared with those without any deep vein thrombosis, there was a statistically significant increase in peripopliteal edema, abnormal fluid-sensitive signal, and abnormal hyperintense T1 signal.

Conclusion

Imaging findings on routine unenhanced MRI have a high rate of concordance with duplex ultrasound performed through the calf in the detection of intramuscular calf vein thrombosis.
Literatur
1.
Zurück zum Zitat Caggiati A, Bergan JJ, Gloviczki P, et al. Nomenclature of the veins of the lower limbs: an international interdisciplinary consensus statement. J Vasc Surg. 2002;36(2):416–22.CrossRef Caggiati A, Bergan JJ, Gloviczki P, et al. Nomenclature of the veins of the lower limbs: an international interdisciplinary consensus statement. J Vasc Surg. 2002;36(2):416–22.CrossRef
2.
Zurück zum Zitat MacDonald PS, Kahn SR, Miller N, Obrand D. Short-term natural history of isolated gastrocnemius and soleal vein thrombosis. J Vasc Surg. 2003;37(3):523–7.CrossRef MacDonald PS, Kahn SR, Miller N, Obrand D. Short-term natural history of isolated gastrocnemius and soleal vein thrombosis. J Vasc Surg. 2003;37(3):523–7.CrossRef
3.
Zurück zum Zitat Gillet JL, Perrin MR, Allaert FA. Short-term and mid-term outcome of isolated symptomatic muscular calf vein thrombosis. J Vasc Surg. 2007;46(3):513–9.CrossRef Gillet JL, Perrin MR, Allaert FA. Short-term and mid-term outcome of isolated symptomatic muscular calf vein thrombosis. J Vasc Surg. 2007;46(3):513–9.CrossRef
4.
Zurück zum Zitat Hill SL, Holtzman GI, Martin D, Evans P, Toler W, Goad K. The origin of lower extremity deep vein thrombi in acute venous thrombosis. Am J Surg. 1997;173(6):485–90.CrossRef Hill SL, Holtzman GI, Martin D, Evans P, Toler W, Goad K. The origin of lower extremity deep vein thrombi in acute venous thrombosis. Am J Surg. 1997;173(6):485–90.CrossRef
5.
Zurück zum Zitat Labropoulos N, Webb M, Kang SS, et al. Patterns and distribution of isolated calf deep vein thrombosis. J Vasc Surg. 1999;30(5):787–91.CrossRef Labropoulos N, Webb M, Kang SS, et al. Patterns and distribution of isolated calf deep vein thrombosis. J Vasc Surg. 1999;30(5):787–91.CrossRef
6.
Zurück zum Zitat De Maeseneer MG, Bochanen N, van Rooijen G, Neglén P. Analysis of 1,338 patients with acute lower limb deep venous thrombosis (DVT) supports the inadequacy of the term “proximal DVT”. Eur J Vasc Endovasc Surg. 2016;51(3):415–20.CrossRef De Maeseneer MG, Bochanen N, van Rooijen G, Neglén P. Analysis of 1,338 patients with acute lower limb deep venous thrombosis (DVT) supports the inadequacy of the term “proximal DVT”. Eur J Vasc Endovasc Surg. 2016;51(3):415–20.CrossRef
7.
Zurück zum Zitat Rose SC, Zwiebel WJ, Miller FJ. Distribution of acute lower extremity deep venous thrombosis in symptomatic and asymptomatic patients: imaging implications. J Ultrasound Med. 1994;13(4):243–50.CrossRef Rose SC, Zwiebel WJ, Miller FJ. Distribution of acute lower extremity deep venous thrombosis in symptomatic and asymptomatic patients: imaging implications. J Ultrasound Med. 1994;13(4):243–50.CrossRef
8.
Zurück zum Zitat Goodacre S, Sampson F, Thomas S, Van Beek E, Sutton A. Systematic review and meta-analysis of the diagnostic accuracy of ultrasonography for deep vein thrombosis. BMC Med Imaging 5:6. Goodacre S, Sampson F, Thomas S, Van Beek E, Sutton A. Systematic review and meta-analysis of the diagnostic accuracy of ultrasonography for deep vein thrombosis. BMC Med Imaging 5:6.
9.
Zurück zum Zitat Parellada AJ, Morrison WB, Reiter SB, et al. Unexpected lower extremity deep venous thrombosis simulating musculoskeletal pathology. Skeletal Radiol. 2006;35(9):659–64.CrossRef Parellada AJ, Morrison WB, Reiter SB, et al. Unexpected lower extremity deep venous thrombosis simulating musculoskeletal pathology. Skeletal Radiol. 2006;35(9):659–64.CrossRef
10.
Zurück zum Zitat Shulman RM, Buchan C, Bleakney RR, White LM. Low prevalence of unexpected popliteal DVT detected on routine MRI. Clin Imaging. 2016;40(1):79–85.CrossRef Shulman RM, Buchan C, Bleakney RR, White LM. Low prevalence of unexpected popliteal DVT detected on routine MRI. Clin Imaging. 2016;40(1):79–85.CrossRef
11.
Zurück zum Zitat Liu PT, Ilaslan H. Unicompartmental muscle edema: an early sign of deep venous thrombosis. Skeletal Radiol. 2003;32(1):41–5.CrossRef Liu PT, Ilaslan H. Unicompartmental muscle edema: an early sign of deep venous thrombosis. Skeletal Radiol. 2003;32(1):41–5.CrossRef
12.
Zurück zum Zitat Westerbeek RE, Van Rooden CJ, Tan M, et al. Magnetic resonance direct thrombus imaging of the evolution of acute deep vein thrombosis of the leg. J Thromb Haemost. 2008;6(7):1087–92.CrossRef Westerbeek RE, Van Rooden CJ, Tan M, et al. Magnetic resonance direct thrombus imaging of the evolution of acute deep vein thrombosis of the leg. J Thromb Haemost. 2008;6(7):1087–92.CrossRef
13.
Zurück zum Zitat Sampson FC, Goodacre SW, Thomas SM, van Beek EJR. The accuracy of MRI in diagnosis of suspected deep vein thrombosis: systematic review and meta-analysis. Eur Radiol. 2007;17(1):175–81.CrossRef Sampson FC, Goodacre SW, Thomas SM, van Beek EJR. The accuracy of MRI in diagnosis of suspected deep vein thrombosis: systematic review and meta-analysis. Eur Radiol. 2007;17(1):175–81.CrossRef
14.
Zurück zum Zitat Katz DS, Fauauff KF, Kranz AO, Hon M. Imaging of deep venous thrombosis: a multimodality overview. Appl Radiol. 2014;43(3):6–16. Katz DS, Fauauff KF, Kranz AO, Hon M. Imaging of deep venous thrombosis: a multimodality overview. Appl Radiol. 2014;43(3):6–16.
15.
Zurück zum Zitat Campbell I. Chi-squared and Fisher-Irwin tests of two-by-two tables with small sample recommendations. Stat Med. 2007;26(19):3661–75.CrossRef Campbell I. Chi-squared and Fisher-Irwin tests of two-by-two tables with small sample recommendations. Stat Med. 2007;26(19):3661–75.CrossRef
16.
Zurück zum Zitat Smitaman E, Flores DV, Mejía Gómez C, Pathria MN. MR imaging of atraumatic muscle disorders. Radiographics. 2018;38(2):500–22.CrossRef Smitaman E, Flores DV, Mejía Gómez C, Pathria MN. MR imaging of atraumatic muscle disorders. Radiographics. 2018;38(2):500–22.CrossRef
17.
Zurück zum Zitat Flores DV, Mejía Gómez C, Estrada-Castrillón M, Smitaman E, Pathria MN. MR imaging of muscle trauma: anatomy, biomechanics, pathophysiology, and imaging appearance. Radiographics. 2018;38(1):124–48.CrossRef Flores DV, Mejía Gómez C, Estrada-Castrillón M, Smitaman E, Pathria MN. MR imaging of muscle trauma: anatomy, biomechanics, pathophysiology, and imaging appearance. Radiographics. 2018;38(1):124–48.CrossRef
18.
Zurück zum Zitat Sule AA, Chin TJ, Handa P, Earnest A. Should symptomatic, isolated distal deep vein thrombosis be treated with anticoagulation? Int J Angiol. 2009;18:83–7.CrossRef Sule AA, Chin TJ, Handa P, Earnest A. Should symptomatic, isolated distal deep vein thrombosis be treated with anticoagulation? Int J Angiol. 2009;18:83–7.CrossRef
19.
Zurück zum Zitat Masuda E, Kistner RL, Musikasinthorn C, Liquido F, Geling O, He Q. The controversy of managing calf vein thrombosis. J Vasc Surg. 2012;55(2):550–61.CrossRef Masuda E, Kistner RL, Musikasinthorn C, Liquido F, Geling O, He Q. The controversy of managing calf vein thrombosis. J Vasc Surg. 2012;55(2):550–61.CrossRef
20.
Zurück zum Zitat De Martino RR, Wallaert JB, Rossi AP, Zbehlik AJ, Suckow B, Walsh DB. A meta-analysis of anticoagulation for calf deep venous thrombosis. J Vasc Surg. 2012;56(1):228–31.CrossRef De Martino RR, Wallaert JB, Rossi AP, Zbehlik AJ, Suckow B, Walsh DB. A meta-analysis of anticoagulation for calf deep venous thrombosis. J Vasc Surg. 2012;56(1):228–31.CrossRef
21.
Zurück zum Zitat Utter GH, Dhillon TS, Salcedo ES, et al. Therapeutic anticoagulation for isolated calf deep vein thrombosis. JAMA Surg. 2016;151(9):e161770.CrossRef Utter GH, Dhillon TS, Salcedo ES, et al. Therapeutic anticoagulation for isolated calf deep vein thrombosis. JAMA Surg. 2016;151(9):e161770.CrossRef
22.
Zurück zum Zitat Righini M, Galanaud JP, Guenneguez H, et al. Anticoagulant therapy for symptomatic calf deep vein thrombosis (CACTUS): a randomised, double-blinded, placebo-controlled trial. Lancet Haematol. 2016;3(12):e556–62.CrossRef Righini M, Galanaud JP, Guenneguez H, et al. Anticoagulant therapy for symptomatic calf deep vein thrombosis (CACTUS): a randomised, double-blinded, placebo-controlled trial. Lancet Haematol. 2016;3(12):e556–62.CrossRef
23.
Zurück zum Zitat Schwarz T, Buschmann L, Beyer J, Halbritter K, Rastan A, Schellong S. Therapy of isolated calf muscle vein thrombosis: a randomized, controlled study. J Vasc Surg. 2010;52(5):1246–50.CrossRef Schwarz T, Buschmann L, Beyer J, Halbritter K, Rastan A, Schellong S. Therapy of isolated calf muscle vein thrombosis: a randomized, controlled study. J Vasc Surg. 2010;52(5):1246–50.CrossRef
24.
Zurück zum Zitat Sales CM, Haq F, Bustami R, Sun F. Management of isolated soleal and gastrocnemius vein thrombosis. J Vasc Surg. 2010;52(5):1251–4.CrossRef Sales CM, Haq F, Bustami R, Sun F. Management of isolated soleal and gastrocnemius vein thrombosis. J Vasc Surg. 2010;52(5):1251–4.CrossRef
25.
Zurück zum Zitat Lautz TB, Abbas F, Novis Walsh SJ, et al. Isolated gastrocnemius and soleal vein thrombosis: should these patients receive therapeutic anticoagulation? Ann Surg. 2009;251(4):735–42.CrossRef Lautz TB, Abbas F, Novis Walsh SJ, et al. Isolated gastrocnemius and soleal vein thrombosis: should these patients receive therapeutic anticoagulation? Ann Surg. 2009;251(4):735–42.CrossRef
26.
Zurück zum Zitat Bradley WG Jr, Waluch V, Lai KS, Fernandez EJ, Spalter C. The appearance of rapidly flowing blood on magnetic resonance images. AJR Am J Roentgenol. 1984;143(6):1167–74.CrossRef Bradley WG Jr, Waluch V, Lai KS, Fernandez EJ, Spalter C. The appearance of rapidly flowing blood on magnetic resonance images. AJR Am J Roentgenol. 1984;143(6):1167–74.CrossRef
27.
Zurück zum Zitat Bradley WG Jr, Waluch V. Blood flow: magnetic resonance imaging. Radiology. 1985;154(2):443–50.CrossRef Bradley WG Jr, Waluch V. Blood flow: magnetic resonance imaging. Radiology. 1985;154(2):443–50.CrossRef
28.
Zurück zum Zitat Whittemore AR, Bradley WG, Jinkins JR. Comparison of cocurrent and countercurrent flow-related enhancement in MR imaging. Radiology. 1989;170(1):265–71.CrossRef Whittemore AR, Bradley WG, Jinkins JR. Comparison of cocurrent and countercurrent flow-related enhancement in MR imaging. Radiology. 1989;170(1):265–71.CrossRef
Metadaten
Titel
Characterization of intramuscular calf vein thrombosis on routine knee MRI
verfasst von
David P. Duncan
Michael Taddonio
Eric Y. Chang
Brady K. Huang
Publikationsdatum
26.04.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Skeletal Radiology / Ausgabe 10/2019
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-019-03213-0

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