Yao-Kuang Huang
Nationality
Taiwan
Current Position
Attending Stuff, Div. of Cardiovascular and Thoracic Surgery
Organization
Chia-Yi Chang Gung Memorial Hospital,
Abdominal Aorta & Aortic iliac Session

Topic: Quantitative 2D phase-contrast MRI of leg veins: how this novel tool impacts our superficial venous interventions?

Abstract

Background: The two-dimensional phase-contrast magnetic resonance imaging (2D PC-MRI) has been applied in our institution for leg venous diseases since 2017 and provides a different view toward venous disease.
Purpose: To determine whether two-dimensional phase-contrast magnetic resonance imaging (2D PC-MRI) could upgrade our clinical service.
Materials and Methods:
A retrospective cross-sectional analysis was conducted with the use of 2D PC-MRI from the participants enrolled between April 2017 and Sep 2022. We performed 420 2D PC-MRI and 360 of them with complete QFlow (hemodynamic analysis). Among them 136 patients with symptoms of venous reflux and 44 patients with venous leg ulcers, received 2D PC-MRI for pre-op planning for superficial venous interventions. There are 76 (60 venous reflux and 16 VLU) patients received superficial venous interventions after 2D PC-MRI study and 15 of them received post op 2D PC-MRI. Besides, 20 health volunteers were included in this study.
Result:
All 76 patients received superficial venous interventions recovered smoothly except one recurrent static leg ulcers and 2 pigmentations after sclerotherapy. The 2D PC-MRI excludes the possible pelvic venous lesions in static venous ulcers before superficial venous intervention. There were additional 20% interventions guided by the 2D PC-MR. The QFlow shown the target legs had higher MF and SV in the planned-intervention legs than health volunteers. To minimalize individual bias, we compared the targeted and nontreated limbs of the individual patients preoperatively and postoperatively. We observed that the FFV and ASV increased significantly in the PV segment after intervention, with similar FFV and ASV values
in the EIV segments. VTI and MV increased in the FV segment more than they did in
the PV segments. These results indicate faster and more efficient volume transport though the FV segments after the intervention.
Conclusion:
The 2D PC-MRI can exclude the pelvic venous pathology, unveil the truncal anatomy, digitalize the hemodynamics, and guide the additional ablations/sclerosant injections. It provides the objective venous information before, and even after the venous intervention, which will be useful to physicians and patients.

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