Study of 2D phase contrast magnetic resonance imaging in the diagnosis of iliac vein compression syndrome

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• Clinical Article •

CHENG Shancong CAO Xinshan WANG Zhu HAN Xinqiang

Cite this article as: CHENG S C, CAO X S, WANG Z, et al. Study of 2D phase contrast magnetic resonance imaging in the diagnosis of iliac vein compression syndrome[J]. Chin J Magn Reson Imaging, 2025, 16(1): 146-151. DOI:10.12015/issn.1674-8034.2025.01.022.

Abstract

[Abstract] Objective To investigate the value of 2D phase contrast magnetic resonance imaging (PC MRI) in quantitative analysis of mean blood flow velocity (MV) in patients with iliac vein compression syndrome (IVCS).Materials and Methods Thirty patients (trial group) with IVCS diagnosed by digital subtraction angiography (DSA) in interventional vascular surgery from December 2023 to July 2024 and ten healthy volunteers (control group) were collected. Clinical data of patients were collected and Philips superconducting MRI 1.5 T was performed. On the basis of balance fast field echo (B-FFE) sequences, 2D PC MRI were set vertically on the coronal, sagittal and axial images of the inferior vena cava and both of external iliac vein. The MV values in the region of interest (ROI) in the vertical cross section of the vessels were obtained by using quantitative flow (Q_FLOW) post-processing software. All 2D PC MRI checks forward twice, and the sequence stability is verified by analyzing the consistency of the two scan results (Bland-Altman diagram). Comparing the MV value between both of external iliac veins in two groups to assesses the effect of common iliac vein compression on blood flow. The MV difference of bilateral external iliac veins in the trial group (healthy external iliac MV － affected external iliac MV) was compared with that in the control group (right external iliac MV － left external iliac MV), and the efficacy of velocity difference in diagnosing IVCS was analyzed. The iliac-vena cava pressure gradient measured by central venous catheter (CVC) in interventional procedures was analyzed in correlation with MV in the distal part of the stenosed iliac vein.Results The results of the two scans were highly positively correlated (P < 0.001, all). The MV of the narrow iliac vein was lower than that of the healthy side in the trial group (P < 0.001), and the MV values of bilateral external iliac veins in the control group were not statistically significant (P = 0.518). The MV difference of bilateral external iliac veins was effective in the diagnosis of IVCS, the AUC was 0.939 (95% CI: 0.887 to 0.991), the sensitivity was 81.7% and the specificity was 100.0%. The pressure gradient measured by CVC was negatively correlated with MV at the distal end of the stenotic vein (r = -0.951, P < 0.001).Conclusions 2D PC MRI is reliable and stable in measuring the blood flow velocity of narrow iliac vein. The difference of bilateral external iliac vein MV has high specificity in the diagnosis of IVCS. The relationship of MV and venous pressure is consistent with Bernoulli's principle. 2D PC MRI can be used as a tool for non-invasive diagnosis of IVCS and indirect assessment tool to provide an important reference for the surgical indication of endovascular interventional therapy in patients with IVCS.

[Keywords] iliac vein compression syndrome；2D phase contrast；blood flow rate；pressure gradient；endovascular intervention；magnetic resonance imaging

Contributor Information

CHENG Shancong¹ CAO Xinshan² WANG Zhu¹ HAN Xinqiang^1*

¹ Department of Interventional Medicine and Vascular Surgery, Binzhou Medical University Hospital, Binzhou 256603, China

² Department of Radiology, Binzhou Medical University Hospital, Binzhou 256603, China

Corresponding author: HAN X Q, E-mail: hxq_0543@163.com

Conflicts of interest None.

Publication Information

Received 2024-08-05

Accepted 2025-01-10

DOI: 10.12015/issn.1674-8034.2025.01.022

Text

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