PB0365 - Use of magnetic resonance direct thrombus imaging for diagnostic management of suspected thrombosis in routine clinical practice

Sunday, June 23, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

St

Sophie N.M. ter Haar

PhD student
Department of Internal Medicine, division Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
Leiden, Zuid-Holland, Netherlands

Co-Author(s)

Cd

Cindy M.M. de Jong

PhD Candidate
Department of Internal Medicine, section Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
Leiden, Zuid-Holland, Netherlands
Lv

Lisette van Dam

MD, PhD
Leiden University Medical Center
Leiden, Zuid-Holland, Netherlands
CD

Charlotte Dronkers

MD, PhD
Leiden University Medical Center
Leiden, Zuid-Holland, Netherlands
JE

Jeroen Eikenboom

MD, PhD
Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands
Leiden, Zuid-Holland, Netherlands
Pd

Paul L. den Exter

Hematologist
Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands
Leiden, Zuid-Holland, Netherlands
Gv

Guido van Haren

senior radiology laboratory technician
Leiden University Medical Center
Leiden, Zuid-Holland, Netherlands
MH

Menno V. Huisman

Professor of Medicine
Department of Medicine – Division of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands; Dutch Thrombosis Network, The Netherlands.
Leiden, Zuid-Holland, Netherlands
Tv

Thijs E. van Mens

MD, PhD
Department of Medicine - Thrombosis & Hemostasis, Leiden University Medical Center
Leiden, Zuid-Holland, Netherlands
LS

Lauran Stöger

MD, PhD
Leiden University Medical Center
Leiden, Zuid-Holland, Netherlands
LK

Lucia J.M. Kroft

MD, PhD
Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
Leiden, Zuid-Holland, Netherlands
Erik Klok, MD, PhD, FESC

Leiden University Medical Center

Background: The non-invasive magnetic resonance direct thrombus imaging (MRDTI) technique can be used to diagnose acute deep-vein thrombosis (DVT), without the use of intravenous contrast. MRDTI holds the potential to differentiate between acute and chronic DVT and is helpful in certain clinical situations when diagnosing thrombosis is challenging.

Aims: To evaluate the application of MRDTI in clinical practice, including the frequency and indications of MRDTI scans performed in practice based conditions, its results, impact on treatment decisions, and associated patient outcomes.

Methods: A retrospective study was performed at the Leiden University Medical Center, the Netherlands. MRDTI scans performed since its implementation in patients aged 18 years and older as part of clinical practice for the diagnostic management of suspected thrombosis were evaluated.

Results: Between October 2015 and September 2023, 36 patients had undergone MRDTI for the diagnostic evaluation of thrombosis. MRDTI application increased since the second half of 2019 (5 to 8 scans per year). The most common indication was to differentiate between acute and chronic thrombosis (69%), mainly for suspected recurrent ipsilateral DVT when compression ultrasonography was inconclusive. In 28%, MRDTI was performed to confirm or rule out DVT when other imaging tests were inconclusive, and in 3% as primary diagnostic imaging test. In over a third of the patients, acute thrombosis was diagnosed by MRDTI. MRDTI results determined treatment decisions in all except two patients. One patient had symptomatic thrombosis of the lower extremity within 3 months after an MRDTI of the upper extremity without signs of acute thrombosis (1/23; 4.3%, 95% confidence interval 0.77-21).

Conclusion(s): Over the past 4 years, MRDTI has been used increasingly in our hospital. MRDTI results guided treatment decisions, which confirms the clinical value and feasibility of its application in daily practice.