Visualization of deep veins and detection of deep vein thrombosis (DVT) with balanced turbo field echo (b-TFE) and contrast-enhanced T1 fast field echo (CE-FFE) using a blood pool agent (BPA)

Purpose: To assess image quality, vessel visualization, preliminary diagnostic properties, and interobserver variability of a novel balanced turbo field echo (b‐TFE) sequence and contrast‐enhanced T1 fast field echo (CE‐FFE) sequence with blood pool agent (BPA). Materials and Methods: A total of 15 healthy volunteers and six patients with ultrasound‐verified proximal deep vein thrombosis (DVT) were examined from the inferior vena cava (IVC) to the proximal calf veins. Results: The great majority of deep veins were completely visualized on both sequences. In healthy volunteers the IVC was completely visualized in five b‐TFE and 11 CE‐FFE scans, and partially in seven b‐TFE and four CE‐FFE scans (P = 0.008). Poorest image quality was in the pelvis. Contrast‐to‐noise ratio (CNR) was higher on b‐TFE compared to CE‐FFE, with significant difference in calf images (P = 0.036). Sensitivity was 100% for proximal DVT with both methods. Specificity was 70% (CE‐FFE) and 80% (b‐TFE) for proximal femoral DVT; 100% in distal femoral. Interobserver reliability was kappa 1.0 (b‐TFE), 0.9 (CE‐FFE) for proximal, and overall poor for distal DVT. Conclusion: Contrast‐enhancement did not add valuable information in visualizing deep veins of the lower limbs compared to b‐TFE, though the IVC was slightly better visualized. Diagnostic properties and interobserver reliability of both sequences were good for proximal DVT and poor for distal DVT. J. Magn. Reson. Imaging 2010; 31: 416–424. © 2010 Wiley‐Liss, Inc.