Detection of thrombosis in the portal venous system: comparison of contrast-enhanced MR angiography with intraarterial digital subtraction angiography.

PURPOSE: To determine whether intraarterial digital subtraction angiography (DSA) can be replaced by contrast material-enhanced magnetic resonance (MR) angiography in the assessment of patency or thrombosis of the portal venous system in patients with portal hypertension.

MATERIALS AND METHODS: Thirty-six patients with portal hypertension underwent contrast-enhanced MR angiography and intraarterial DSA for assessment of the portal venous system. The images were evaluated for vessel patency or thrombosis of the portal, splenic, or superior mesenteric vein.

RESULTS: Of the 101 vessels evaluated, 42 were thrombosed. Overall sensitivity, specificity, and accuracy for the detection of thrombosis were 100%, 98%, and 99%, respectively, for MR angiography and 91%, 100%, and 96%, respectively, for DSA; differences between the imaging methods were not statistically significant. Only in four patients with six vessels (6%) were there discordant findings between MR angiography and DSA.

CONCLUSION: Noninvasive contrast-enhanced MR angiography has the potential to replace intraarterial DSA as the standard method to assess the whole portal venous system.