Abstract Number: PB2266
Meeting: ISTH 2020 Congress
Background: Timely diagnosis and treatment of splanchnic vein thrombosis (SVT), which includes portal vein, mesenteric vein, splenic vein and hepatic vein thrombosis, is crucial to prevent morbidity and mortality. However, currently available imaging tests are not able to accurately differentiate acute from chronic SVT, which is essential for adequate management. Magnetic resonance direct thrombus imaging (MRDTI) has been shown to accurately differentiate acute from chronic deep vein thrombosis in the leg and may also be of value in the diagnostic management of SVT.
Aims: This study describes the first optimization phase of the Rhea study (NTR 7061). Our aim was to select and optimize non-contrast-enhanced MRDTI sequences to differentiate acute from chronic SVT.
Methods: Literature was searched for MRDTI sequences, which could be of use for imaging of the splanchnic veins. The most promising sequences were tested in a healthy volunteer in several stages, followed by one patient with acute SVT and two patients with chronic SVT, all diagnosed on (repetitive) contrast-enhanced computed tomography venography, to optimize the MRDTI sequences. All images were evaluated by an expert panel. The Rhea study was approved by all local IRBs and patients provided written informed consent.
Results: Several MRDTI sequences were identified and tested; 3D T1 TFE and 3D T1 Dixon FFE were found to be the most optimal MRDTI sequences for imaging of SVT. The expert panel was able to confirm the diagnosis of acute SVT on the combined two MRDTI sequences (Figure 1) and to exclude acute SVT in the two patients with chronic SVT (Figure 2).
Conclusions: The combination of 3D T1 TFE and 3D T1 Dixon FFE was identified to be the most optimal for SVT imaging. These sequences will be used in the clinical part of the Rhea study in which their test performance on differentiating acute from chronic SVT will be determined.
To cite this abstract in AMA style:van Dam LF, Klok FA, Ageno W, Darwish Murad S, van Haren GR, Huisman MV, Lauw MN, Iglesias del Sol A, Tushuizen ME, Wasser MNJM, Willink Y, Kroft LJM. Optimizing Magnetic Resonance Direct Thrombus Imaging for Differentiating Acute from Chronic Splanchnic Vein Thrombosis [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/optimizing-magnetic-resonance-direct-thrombus-imaging-for-differentiating-acute-from-chronic-splanchnic-vein-thrombosis/. Accessed May 16, 2022.
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