A catalyst for pulmonary edema, Deep Vein Thrombosis (DVT) is an indication which indirect MR Venography (MRV) addresses with particular value. Indirect MRV depicts the entire venous system of the lower limb and detects DVT with a sensitivity and specificity that matches fluoroscopic venography, and with superior vessel coverage. (Source: Kluge A, et al)
The role of CE-MRV in assessing suspected DVT is cited in Cigna Policy 0154.
Value of MRV for Diagnosing and Treating DVT
MRV is a primary comprehensive technique for diagnosing thromboembolism.
- MR can cover the entire deep venous system.
- Follow-up exams are feasible and cardiac MRI can be added to an MR study in progress.
- A combined MR protocol assessing PE (pulmonary embolism) and DVT (deep vein thrombosis) has been shown to detect 17% more cases of thromboembolism compared with separate examinations.
- MRV is superior to duplex sonography for the purpose of ruling out thromboembolic disease. (Source: Kluge A, et al)
Speed and Appropriateness
The combination of multitechnique thoracic MRI for PE and MR venography for DVT is routinely feasible in less than 20 minutes, and provides a “one-stop-shopping approach to diagnose or exclude acute thoracic diseases and DVT.” (Source: Kluge A, et al)
Kluge A, Mueller C, Strunk J, Lange U, Bachmann G. “Experience in 207 Combined MRI Examinations for Acute Pulmonary Embolism and Deep Vein Thrombosis”, American Journal of Roentgenology, 2006; 1686-1694.