The Journal of Bone and Joint Surgery, Vol 77, Issue 11 1639-1649, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc

JOURNAL CONTENTS

Magnetic resonance venography to evaluate the deep venous system of the pelvis in patients who have an acetabular fracture

KD Montgomery, HG Potter and DL Helfet
Hospital for Special Surgery, New York, N.Y. 10021, USA.

We performed a prospective, blinded study to assess and compare the values of preoperative contrast venography and magnetic resonance venography in the detection of deep venous thrombosis in the thigh and pelvis of forty-five consecutive patients who had a displaced acetabular fracture. The magnetic resonance venography and contrast venography were performed an average of seven days (range, one to twenty-nine days) after the injury. Twenty-four asymptomatic thrombi were identified with magnetic resonance venography in fifteen (33 percent) of the patients. Four of the thrombi were in the superficial femoral vein, nine were in the common femoral vein, one was in the external iliac vein, seven were in the internal iliac vein, and three were in the common iliac vein. Ten (42 percent) of the twenty-four thrombi were confirmed with contrast venography; nine of them were located in the thigh. The remaining fourteen thrombi (58 percent) that had been noted on magnetic resonance venography could not be seen with contrast venography because they were located either in the deep pelvic veins or in the uninjured extremity. The thrombi in the internal iliac vein were identified only with magnetic resonance venography. Twelve of the fifteen patients who had thrombi had a filter placed in the inferior vena cava preoperatively. In eight of these patients, the filter was placed because of the findings of magnetic resonance venography alone. Magnetic resonance venography resulted in a change in the therapeutic management of ten (22 per cent) of the forty-five patients. There were no pulmonary emboli. We concluded that magnetic resonance venography is superior to contrast venography for the preoperative evaluation of proximal deep venous thrombosis in patients who have an acetabular fracture. Magnetic resonance venography is non-invasive, does not require the use of contrast medium, images the proximal aspects of both lower extremities simultaneously, and, most importantly, allows for the identification of deep venous thrombosis in the pelvis.
CiteULike    Connotea    Del.icio.us    Technorati    What's this?

This article has been cited by other articles:

				J. P. Stannard, R. R. Lopez-Ben, D. A. Volgas, E. R. Anderson, M. Busbee, D. K. Karr, G. R. McGwin Jr., and J. E. Alonso Prophylaxis Against Deep-Vein Thrombosis Following Trauma: A Prospective, Randomized Comparison of Mechanical and Pharmacologic Prophylaxis J. Bone Joint Surg. Am., February 1, 2006; 88(2): 261 - 266. [Abstract] [Full Text] [PDF]

				N. Steele, R. M. Dodenhoff, A. J. Ward, and M. H. Morse Thromboprophylaxis in pelvic and acetabular trauma surgery: THE ROLE OF EARLY TREATMENT WITH LOW-MOLECULAR-WEIGHT HEPARIN J Bone Joint Surg Br, February 1, 2005; 87-B(2): 209 - 212. [Abstract] [Full Text] [PDF]

				D. G. W. Fraser, A. R. Moody, I. R. Davidson, A. L. Martel, and P. S. Morgan Deep Venous Thrombosis: Diagnosis by Using Venous Enhanced Subtracted Peak Arterial MR Venography versus Conventional Venography Radiology, March 1, 2003; 226(3): 812 - 820. [Abstract] [Full Text] [PDF]

				M. G. Ryan, G. H. Westrich, H. G. Potter, N. Sharrock, L. M. Maun, W. Macaulay, P. Katkin, T. P. Sculco, and E. A. Salvati Effect of Mechanical Compression on the Prevalence of Proximal Deep Venous Thrombosis as Assessed by Magnetic Resonance Venography J. Bone Joint Surg. Am., November 12, 2002; 84(11): 1998 - 2004. [Abstract] [Full Text] [PDF]

				J. Kelly, A. Rudd, R.R. Lewis, and B.J. Hunt Screening for subclinical deep-vein thrombosis QJM, October 1, 2001; 94(10): 511 - 519. [Full Text] [PDF]

				J. P. Stannard, R. S. Riley, M. D. McClenney, R. R. Lopez-Ben, D. A. Volgas, and J. E. Alonso Mechanical Prophylaxis Against Deep-Vein Thrombosis After Pelvic and Acetabular Fractures J. Bone Joint Surg. Am., July 1, 2001; 83(7): 1047 - 1051. [Abstract] [Full Text] [PDF]

				C. E. Spritzer, M. A. Arata, and K. S. Freed Isolated Pelvic Deep Venous Thrombosis: Relative Frequency as Detected with MR Imaging Radiology, May 1, 2001; 219(2): 521 - 525. [Abstract] [Full Text]

				J. Kelly, A. Rudd, R. Lewis, and B. J. Hunt Venous Thromboembolism After Acute Stroke Stroke, January 1, 2001; 32(1): 262 - 267. [Abstract] [Full Text] [PDF]

				E. A. SALVATI, V. D. PELLEGRINI, N. E. SHARROCK, P. A. LOTKE, D. W. MURRAY, H. POTTER, and G. H. WESTRICH Symposium - Recent Advances in Venous Thromboembolic Prophylaxis During and After Total Hip Replacement J. Bone Joint Surg. Am., February 1, 2000; 82(2): 252 - 70. [Full Text]