Lisette van Dam

Detection of UEDVT by MR-NCTI 5 83 Outcomes The primary outcome was the sensitivity and specificity of MR-NCTI for the diagnosis of UEDVT. The secondary outcome was the interobserver agreement of MR-NCTI reading for suspected UEDVT. Definitions An unlikely clinical probability according the Constans rule was defined as a score of less than 2 points ( Table 2 ). 15 A normal D-dimer test was defined as normal according to the assay dependent threshold, which differed between the different assays used in the study. A positive CUS for UEDVT was defined as the presence of venous segment area of the upper extremity including subclavian, axillary, brachial or brachiocephalic vein with > 4mm of non-compressibility. 3 A positive (CT) venography for UEDVT was defined as presence of a constant intraluminal filling defect in the deep veins of the arms (subclavian, axillary, brachial or brachiocephalic vein), as shown on at least two projections. A positiveMR-NCTI scan for UEDVT was defined as an increased or aberrant signal intensity in the location of the subclavian, axillary, brachial or brachiocephalic vein against the suppressed background. 14 Pulmonary embolism (PE) during follow-up was diagnosed with computed tomography pulmonary angiography (CTPA) if there was an intraluminal defect in a segmental or greater pulmonary artery. 3,18 For ventilation-perfusion (VQ) scanning PE was defined as a perfusion defect, segmental or more proximal on lung perfusion scan, and in presence of a mismatch with the concomitant ventilation scan. PE found at autopsy was also considered diagnostic of VTE. Death related to PE was defined according the following criteria 1) Certain: hypotension, hypoxia, cardiac arrest with no other explanation other than PE with autopsy or radiographic confirmation; 2) Highly probable: criterion for certain fulfilled but another plausible factor/disease as cause of death also present; 3) Probable: other cause suspected based on clinical evidence but 100% certainty not available and 4) Unlikely: all other cases. 19