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CC BY-NC-ND 4.0 · Thromb Haemost 2020; 120(10): 1463-1473
DOI: 10.1055/s-0040-1714280
Stroke, Systemic or Venous Thromboembolism

High Signal Intensity on Diffusion-Weighted Images Reflects Acute Phase of Deep Vein Thrombus

Toshihiro Gi
1   Department of Pathology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
,
Yasuyoshi Kuroiwa
1   Department of Pathology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
2   Department of Radiological Technology, Koga General Hospital, Miyazaki, Japan
,
Atsushi Yamashita
1   Department of Pathology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
,
Yuko Mizutani
3   Division of Radiology, Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan
,
Taketoshi Asanuma
4   Development of Veterinary Medicine, Faculty of Veterinary Medicine, Imabari Campus, Okayama University of Science, Imabari, Japan
,
Tosiaki Miyati
5   Institute of Medical, Pharmaceutical and Health Sciences, Faculty of Health Sciences, Kanazawa University, Ishikawa, Japan
,
Kazunari Maekawa
1   Department of Pathology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
,
Murasaki Aman
6   Department of Diagnostic Pathology, University of Miyazaki Hospital, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
,
Takuroh Imamura
7   Department of Internal Medicine, Koga General Hospital, Miyazaki, Japan
,
Yujiro Asada
1   Department of Pathology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
› Author Affiliations Funding This study was partly supported by Grants-in-Aid for Scientific Research (Nos. JP15K09963, JP16K09019, JP18K15083, JP19K07437, JP19H03445, JP20K08085) from Japan Society for the Promotion of Science, the President's Strategic Priority Budget from Miyazaki University, Clinical Research from Miyazaki University Hospital, and a Research Promotion Grant from The Japanese Society on Thrombosis and Hemostasis.
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Abstract

The effects of antithrombotic therapy on deep vein thrombosis (DVT) can be affected by thrombus age, which cannot be reliably determined by noninvasive imaging modalities. We investigated whether magnetic resonance (MR) diffusion-weighted imaging (DWI) can localize and determine the age of venous thrombus in patients with DVT, animal models, and human blood in vitro. Signal intensity (SI) on DWI and the apparent diffusion coefficient (ADC) of thrombi were assessed in eight patients with DVT using a 1.5-T MR imaging (MRI) system. We assessed the organizing processes as venous thrombus developed in the rabbit jugular vein using a 3.0-T MRI system over time. We also assessed MRI signals of human blood in vitro using the 1.5-T MRI system. Venous thrombi were detected by DWI as areas of high or mixed high and iso SI in all patients. The ADCs were lower in the proximal, than in the distal portion of the thrombi. The thrombi of rabbit jugular veins histologically organized in a time-dependent manner, with high SI on DWI at 4 hours, mixed high and iso SI at 1 and 2 weeks, and iso SI at 3 weeks. The ADC correlated negatively with erythrocyte content, and positively with smooth muscle cells, macrophages, hemosiderin, and collagen content. MRI signals of human blood in vitro showed that ADCs were affected by erythrocyte content, but not by blood clotting. MR-DWI can detect venous thrombus, and high SI on DWI accompanied by a low ADC might reflect erythrocyte-rich, acute-phase thrombi.

Keywords

deep vein thrombosis - diffusion-weighted imaging - erythrocyte - magnetic resonance imaging - pathology

Supplementary Material



Publication History

Received: 10 April 2020

Accepted: 10 June 2020

Article published online:
03 August 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Stuttgart · New York

 

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