BACKGROUND To explore the diagnostic performance of triggered angiography non-contrast-enhanced magnetic resonance imaging (TRANCE-MRI) for the evaluation of venous pathology of the lower extremity. METHODS This was a single-centre prospective cohort study of 25 patients with suspected venous disease in the lower extremities. Each patient received Doppler ultrasonography (for venous evaluation) before the scheduled TRANCE-MRI (for venous and arterial evaluations) on a 1.5 T MR scanner (Philips Ingenia, Philips Healthcare, Best, the Netherlands), followed by lymphography and computed tomography angiography that were arranged according to the diagnostic indications. RESULTS The sensitivity, specificity and accuracy of TRANCE-MRI were 85.7%, 88/9 and 88%, respectively. The inter-rater agreement for deep vein thrombosis (DVT) of the thigh between the ultrasonography and TRANCE-MRI results was substantial agreement (Cohen's kappa κ, 0.72). In ultrasonography-negative cases, TRANCE-MRI detected four additional cases (16%, 4/25) of DVT; three cases (12%, 3/25) of venous compression caused by pelvic lymphadenopathy, hip prosthesis or knee joint effusion; one case (4%, 1/25) of vena cava anomaly; two cases (8%, 2/25) of occult peripheral artery disease (PAD); and one case (4%, 1/25) of an occluded bypass graft. CONCLUSION TRANCE-MRI can be used as an alternative and objective tool for assessing lower extremity diseases, especially suspected venous pathology. Compared with ultrasonography, TRANCE-MRI plays a better role in assessing varicose veins of the lower extremities and deep veins of the pelvis and abdomen. However, false-positive results may occur in the left common iliac vein of elderly patients. Finally, occult PAD rarely occurs in patients with suspected lower extremity venous disease. Therefore, we recommend performing the TRANCE-MRV protocol instead of the full protocol (MRV + MRA) in the clinical setting in patients with venous scenarios.

中文翻译：

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使用触发性血管造影非造影增强磁共振成像技术评估下肢的静脉病理。

背景技术探讨触发式血管造影非造影磁共振成像（TRANCE-MRI）在评估下肢静脉病变方面的诊断性能。方法这是一项对25名下肢疑似静脉疾病患者的单中心前瞻性队列研究。每位患者在1.5 T MR扫描仪（Philips Ingenia，Philips Healthcare，Best，荷兰）上进行预定的TRANCE-MRI（静脉和动脉评估）之前接受多普勒超声检查（静脉评估），然后进行淋巴摄影和计算机断层摄影血管造影，根据诊断指征进行排列。结果TRANCE-MRI的敏感性，特异性和准确性分别为85.7％，88/9和88％。超声检查与TRANCE-MRI检查结果之间的大腿深静脉血栓形成（DVT）评分者之间的一致性是基本一致的（Cohen kappaκ，0.72）。在超声检查阴性的病例中，TRANCE-MRI检出了另外四例DVT（16％，4/25）；由盆腔淋巴结肿大，髋关节假体或膝关节积液引起的静脉压迫3例（12％，3/25）; 1例（4％，1/25）的腔静脉异常; 隐匿性外周动脉疾病（PAD）2例（8％，2/25）；一例（4％，1/25）被阻塞的旁路移植物。结论TRANCE-MRI可作为评估下肢疾病（尤其是可疑静脉病理）的替代和客观工具。与超声检查相比，TRANCE-MRI在评估下肢静脉曲张以及骨盆和腹部深静脉方面起更好的作用。但是，老年患者的左common总静脉可能会出现假阳性结果。最后，在疑似下肢静脉疾病的患者中很少发生隐匿性PAD。因此，我们建议在有静脉情况的患者的临床环境中，执行TRANCE-MRV方案而不是完整方案（MRV + MRA）。