Experimental multiparametric magnetic resonance imaging characterization of iliocaval venous thrombosis pathological changes

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dc.citation.articleNumber101895en_US
dc.citation.issueNumber4en_US
dc.citation.journalTitleJournal of Vascular Surgery: Venous and Lymphatic Disordersen_US
dc.citation.volumeNumber12en_US
dc.contributor.authorMagnus, Louisen_US
dc.contributor.authorSchwein, Adelineen_US
dc.contributor.authorChinnadurai, Ponrajen_US
dc.contributor.authorFontaine, Killianen_US
dc.contributor.authorAutry, Kyleen_US
dc.contributor.authorShah, Dipan J.en_US
dc.contributor.authorGrande-Allen, Kathryn Janeen_US
dc.contributor.authorChakfé, Nabilen_US
dc.contributor.authorBismuth, Jeanen_US
dc.date.accessioned2024-08-07T19:14:59Zen_US
dc.date.available2024-08-07T19:14:59Zen_US
dc.date.issued2024en_US
dc.description.abstractObjective Iliocaval thrombotic obstruction is a challenging condition, especially because thrombus age and corresponding pathological remodeling at presentation are unknown, which directly impacts management. Our aim was to assess the ability of magnetic resonance imaging (MRI) in determining age thresholds of experimentally created inferior vena cava (IVC) thrombosis in pigs. Methods We used a previously described swine model of IVC thrombosis. The animals underwent MRI at baseline, immediately after thrombosis creation, and after a follow-up period extending from 2 to 28 days. Thirteen pigs were divided into three groups according to disease chronicity: acute group (AG; n = 5), subacute group (SAG; n = 4), and chronic group (CG; n = 4), with a mean thrombosis age of 6.4 ± 2.5 days, 15.7 ± 2.8 days, and 28 ± 5.7 days, respectively. A T1-weighted volumetric interpolated breath-hold examination sequence was used to anatomically delineate IVC thrombus as a region of interest. Three other MRI sequences were used to assess the thrombus signal. Results The Kruskal-Wallis test showed a statistically significant difference in T1 relaxation times after contrast injection (P = .026) between the three groups of chronicity. The AG (360.2 ± 102.5 ms) was significantly different from the CG (336.7 ± 55.2 ms; P = .003), and the SAG (354.1 ± 89.7 ms) was significantly different from the AG (P = .027). There was a statistically significant difference in native T2 relaxation times (P = .038) between the three groups. The AG (160 ± 86.7 ms) was significantly different from the SAG (142.3 ± 55.4 ms; P = .027), and the SAG was significantly different from the CG (178.4 ± 11.7 ms; P = .004). Conclusions This study highlighted MRI characteristics in a swine model that might have the potential to significantly differentiate subacute and chronic stages from an acute stage of deep vein thrombosis in humans. Further clinical studies in humans are warranted. Clinical Relevance In addition to providing a better understanding of venous thrombosis remodeling over time, magnetic resonance imaging has the potential to be a tool that could allow us to characterize the composition of venous thrombus over an interval, allowing for a refined analysis of the local evolution of venous thrombosis. We propose a noninvasive and innovative method to characterize different thresholds of chronicity with magnetic resonance imaging features of central deep vein thrombosis of the inferior vena cava experimentally obtained using a totally endovascular in vivo swine model, mimicking human pathophysiology. Being able to determine these features noninvasively is critical for vascular specialists when it comes to choosing between fibrinolytic therapy, percutaneous thrombectomy, or surgical management.en_US
dc.identifier.citationMagnus, L., Schwein, A., Chinnadurai, P., Fontaine, K., Autry, K., Shah, D. J., Grande-Allen, K. J., Chakfé, N., & Bismuth, J. (2024). Experimental multiparametric magnetic resonance imaging characterization of iliocaval venous thrombosis pathological changes. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 12(4), 101895. https://doi.org/10.1016/j.jvsv.2024.101895en_US
dc.identifier.digital1-s2-0-S2213333X24002130-mainen_US
dc.identifier.doihttps://doi.org/10.1016/j.jvsv.2024.101895en_US
dc.identifier.urihttps://hdl.handle.net/1911/117596en_US
dc.language.isoengen_US
dc.publisherElsevieren_US
dc.rightsExcept where otherwise noted, this work is licensed under a Creative Commons Attribution (CC BY) license.  Permission to reuse, publish, or reproduce the work beyond the terms of the license or beyond the bounds of fair use or other exemptions to copyright law must be obtained from the copyright holder.en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en_US
dc.titleExperimental multiparametric magnetic resonance imaging characterization of iliocaval venous thrombosis pathological changesen_US
dc.typeJournal articleen_US
dc.type.dcmiTexten_US
dc.type.publicationpublisher versionen_US
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