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CT IVC venogram: normalized quantitative criteria for patency and thrombosis
Marina Mityul1, David J Kim1, Amber Salter2
1Mallinckrodt Institute of Radiology, Washington University School of Medicine, Campus Box 8131, 510 S. Kingshighway Blvd, St Louis, MO, 63110, USA.
Abdominal Radiology (New York)
|February 22, 2019
Summary
A normal vein to artery attenuation ratio on CT IVC venogram is approximately 0.91. A ratio below 0.67 strongly suggests the presence of venous thrombus, aiding in diagnosis.
Area of Science:
- Radiology
- Vascular Imaging
- Diagnostic Accuracy
Background:
- Deep vein thrombosis (DVT) diagnosis relies on imaging techniques.
- Computed Tomography Inferior Vena Cava (CT IVC) venography is used to visualize venous structures.
- Establishing normal imaging parameters is crucial for accurate interpretation.
Purpose of the Study:
- To establish normal attenuation ratios between veins and arteries in CT IVC venography.
- To determine a diagnostic vascular attenuation ratio for identifying venous thrombus.
Main Methods:
- Retrospective analysis of 56 CT IVC venograms.
- Calculation of vein-to-artery attenuation ratios in four venous stations.
- Receiver operating characteristic (ROC) analysis to determine a thrombus-specific threshold.
Main Results:
- Median normal attenuation ratios ranged from 0.89 to 0.91.
- ROC analysis yielded an area under the curve (AUC) of 0.994.
- A threshold ratio of 0.67 demonstrated high sensitivity (100%) and specificity (97.5%) for thrombus detection.
Conclusions:
- The normal vein-to-artery attenuation ratio on CT IVC venography is approximately 0.91.
- A ratio less than 0.67 is highly suggestive of venous thrombus.
- This ratio serves as a valuable diagnostic tool for thrombus identification.
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