Preliminary experience with magnetic resonance venography: comparison with findings at surgical exploration

While conventional magnetic resonance imaging has been described for the evaluation of the venous system, we have recently developed the technique of magnetic resonance venography (MRV), which generates three-dimensional projection venograms. Our purpose was to determine if MRV reliably images the venous system by comparison with findings at surgical exploration. Thirteen of fourteen consecutive patients undergoing bypass surgery (26 limbs) were studied by 2D time-of-flight MRV preoperatively from the inguinal ligament to the ankle bilaterally. The average examination time was 50 min. The size and quality of each saphenous vein were recorded at the saphenofemoral junction, mid-thigh, knee, mid-calf, and malleolus. Intraoperatively the quality and size of each vein were measured in situ and when distended by saline. Twelve veins were of good quality. MRV predicted this in every case. One vein, found to be recanalized, had an abnormally thick wall noted on MRV. MRV measurements of average vein size were intermediate between that of the in situ and distended vein and correlated most closely with the distended vein (R = 0.74, P < 0.001). The superficial and deep femoral veins and lesser saphenous veins were routinely visualized by MRV; thus a complete map of all available vein was obtained by a single study. It is concluded that MRV is an accurate method of venous imaging as confirmed by findings at operative exploration. This new technique holds promise as a noninvasive method for evaluation of the venous system and warrants further investigation.