Differentiation of deep venous thrombosis from femoral vein mixing artifact on routine abdominopelvic CT

Verfasser / Beitragende:
[Ankur Doshi, David Hoffman, Andrea Kierans, Justin Ream, Andrew Rosenkrantz]
Ort, Verlag, Jahr:
2015
Enthalten in:
Abdominal Imaging, 40/8(2015-10-01), 3191-3195
Format:
Artikel (online)
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024 7 0 |a 10.1007/s00261-015-0525-6  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00261-015-0525-6 
245 0 0 |a Differentiation of deep venous thrombosis from femoral vein mixing artifact on routine abdominopelvic CT  |h [Elektronische Daten]  |c [Ankur Doshi, David Hoffman, Andrea Kierans, Justin Ream, Andrew Rosenkrantz] 
520 3 |a 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±0.2cm; R2 0.3±0.4 vs. 0.0±0.1cm, 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. 
540 |a Springer Science+Business Media New York, 2015 
690 7 |a DVT  |2 nationallicence 
690 7 |a Femoral vein  |2 nationallicence 
690 7 |a Mixing artifact  |2 nationallicence 
700 1 |a Doshi  |D Ankur  |u Department of Radiology, NYU School of Medicine, NYU Langone Medical Center, 550 First Avenue, 10016, New York, NY, USA  |4 aut 
700 1 |a Hoffman  |D David  |u Department of Radiology, NYU School of Medicine, NYU Langone Medical Center, 550 First Avenue, 10016, New York, NY, USA  |4 aut 
700 1 |a Kierans  |D Andrea  |u Department of Radiology, New York-Presbyterian Hospital / Weill Cornell Medical Center, 525 East 68th Street, 10021, New York, NY, USA  |4 aut 
700 1 |a Ream  |D Justin  |u Department of Radiology, NYU School of Medicine, NYU Langone Medical Center, 550 First Avenue, 10016, New York, NY, USA  |4 aut 
700 1 |a Rosenkrantz  |D Andrew  |u Department of Radiology, NYU School of Medicine, NYU Langone Medical Center, 550 First Avenue, 10016, New York, NY, USA  |4 aut 
773 0 |t Abdominal Imaging  |d Springer US; http://www.springer-ny.com  |g 40/8(2015-10-01), 3191-3195  |x 0942-8925  |q 40:8<3191  |1 2015  |2 40  |o 261 
856 4 0 |u https://doi.org/10.1007/s00261-015-0525-6  |q text/html  |z Onlinezugriff via DOI 
898 |a BK010053  |b XK010053  |c XK010000 
900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00261-015-0525-6  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Doshi  |D Ankur  |u Department of Radiology, NYU School of Medicine, NYU Langone Medical Center, 550 First Avenue, 10016, New York, NY, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Hoffman  |D David  |u Department of Radiology, NYU School of Medicine, NYU Langone Medical Center, 550 First Avenue, 10016, New York, NY, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Kierans  |D Andrea  |u Department of Radiology, New York-Presbyterian Hospital / Weill Cornell Medical Center, 525 East 68th Street, 10021, New York, NY, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Ream  |D Justin  |u Department of Radiology, NYU School of Medicine, NYU Langone Medical Center, 550 First Avenue, 10016, New York, NY, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Rosenkrantz  |D Andrew  |u Department of Radiology, NYU School of Medicine, NYU Langone Medical Center, 550 First Avenue, 10016, New York, NY, USA  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Abdominal Imaging  |d Springer US; http://www.springer-ny.com  |g 40/8(2015-10-01), 3191-3195  |x 0942-8925  |q 40:8<3191  |1 2015  |2 40  |o 261