Pelvic and lower extremity veins: contrast-enhanced three-dimensional MR venography with a dedicated vascular coil-initial experience.

PURPOSE To assess the performance of three-dimensional (3D) magnetic resonance (MR) venography of the pelvis and lower extremities in patients without acute deep venous thrombosis by using a lower extremity vascular coil and pedal injection of paramagnetic contrast material. MATERIALS AND METHODS Conventional and MR venography were performed in 35 legs in 25 patients referred for evaluation of varicosities (n = 8) and postthrombotic changes (n = 7) and assessment of the great saphenous veins prior to bypass surgery (n = 10). Injection of 120 mL of diluted (1:15) gadopentetate dimeglumine into a pedal vein was performed manually at a rate of 1 mL/sec, and 3D gradient-recalled echo data sets of the upper and lower veins were collected. Conventional and MR venographic images were analyzed separately in a blinded fashion. RESULTS MR image quality was comparable to that of conventional venograms. Varicose changes of the great and small saphenous veins (sensitivity, 94% [44 of 47]; specificity, 96% [89 of 93]) were assessed as reliably as their status before bypass surgery (sensitivity, 98% [53 of 54]; specificity, 92% [47 of 51]). Postthrombotic changes were diagnosed with a sensitivity of 100% [13 of 13] and a specificity of 98% [88 of 90]. CONCLUSION Direct 3D MR venography comprehensively displays the lower extremity venous system and permits assessment of postthrombotic and varicose changes and the bypass suitability of the saphenous vein.