Relaxation-Enhanced Angiography without Contrast and Triggering (REACT) for pelvic MR venography in comparison to...

To evaluate the imaging capabilities of the REACT pulse sequence in pelvic venous vessels compared to conventional non-contrast pulse sequences.

In addition to routine MRI venography, non-contrast enhanced REACT pulse sequence was performed in 4 healthy volunteers and 21 patients with suspected or known deep venous thrombosis and post thrombotic syndrome. Acquired images were independently interpreted by two MRI radiologists. The sequence performance was subjectively evaluated on a four-point scale regarding the delineation of small peripheral, midsize and large proximal venous vessels, the imaging of vascular pathologies, and the degradation due to artifacts. To evaluate statistical differences in diagnostic accuracy Friedman's test with Dunn's correction was used.

REACT depicted the peripheral veins superior to bTFE and T2-TSE with an average score of 3.39 compared to 2.33 in bTFE and 1.77 in T2-TSE. In midsize vessels REACT performed significantly better than T2-TSE (1.94) and bTFE (2.68) with a score of 3.64. For the large proximal vessels REACT (3.39), bTFE (3.33) and T2-TSE (3.56) performed equally without statistical difference. Visibility of venous pathologies was found to be equal between REACT (3.62), bTFE (3.51) and T2-TSE (3.52). The image degradation due to artifacts was rated best in T2-TSE (3.56), followed by REACT (3.39) and bTFE (3.33).

REACT is a promising tool for the visualization of the pelvic venous system using magnetic resonance imaging.