Lisette van Dam

Detection of UEDVT by MR-NCTI 5 87 Table 3. Baseline characteristics of 60 patients with suspected upper extremity deep vein thrombosis (UEDVT) Patients with confirmed UEDVT Patients with UEDVT excluded Mean age (+/- SD) – years 50 (16) 58 (17) Male – no (%) 16 (53) 18 (60) Median duration of complaints (IQR) – days 4.0 (2.0-8.0) 2.5 (2.0-6.3) Malignancy – no (%) 7 (23) 10 (33) Trauma/surgery during the past 4 weeks – no (%) 5 (17) 4 (13) Hormone (replacement) therapy – no (%) 5 (17) 2 (6.7) Paralysis, paresis or plaster immobilization – no (%) 0 (0) 1 (3.3) Intravenous material in subclavian or jugular vein (catheter or access device) 7 (23) 5 (17) SD: standard deviation, IQR: interquartile range Primary outcome MR-NCTI was positive in 28 of 30 patients with UEDVT and normal in two patients ( Table 4 and 5 ). Of these two, the first patient was a 66-year-old female patient with known leiomyosarcoma. She presented with a six-day episode of pain and swelling of the left upper and lower arm in which a central venous catheter was in situ. At presentation, the patient had a likely clinical probability according the Constans rule (3 points) and D-dimer level of 1975 ng/mL. CT venography was performed because of an inconclusive CUS examination. CT showed a hypoplastic left internal jugular vein with an intraluminal hypodensity, compatible with thrombosis, at the confluence and in the proximal hypoplastic left internal jugular vein. MR- NCTI was performed at 48 hours after the diagnosis. MRDTI and 3D TSE-SPAIR sequences were considered diagnostic for DVT in the left jugular vein according one reviewer and negative for DVT according to the second reviewer. Consensus reading resulted in a negative DVT diagnosis. The second case with UEDVT and a normal MR-NCTI was a 52-year-old male patient presenting with pain and pitting edema of the right arm since three days. At presentation, the patient had a likely clinical probability according the Constans rule (2 points) and a D-dimer result of 1600 ng/mL. CT venography showed thrombosis in the right subclavian vein. MR- NCTI scan was performed at two hours after the diagnosis. Both MRDTI and 3D