Imaging

Thrombophlebitis

Preliminary Diagnosis: Thrombophlebitis

I. What imaging technique is first-line for this diagnosis

  • CTA/CTV of the structure of interest.

II. Describe the advantages and disadvantages of this technique for diagnosis of thrombophlebitis.

Advantages

  • Offers exquisite detail of the underlying vascular structures and helps delineate and characterize inflammation, clot, or other vascular irregularity.

  • Highly sensitive and specific in detailing and diagnosing a primary pathological process and characterizing any secondary complications.

Disadvantages

  • Exposes patients to ionizing radiation.

III. What are the contraindications for the first-line imaging technique?

  • May be contraindicated in pregnant patients.

  • Relative contraindication to intravenous contrast in patients with renal failure or contrast allergy

IV. What alternative imaging techniques are available?

  • MRA/MRV imaging.

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of thrombophlebitis.

MRA/MRV imaging

Advantages

  • Does not expose patients to ionizing radiation.

  • May be performed without contrast per time-of-flight protocol.

Disadvantages

  • Expensive

  • Time-consuming

  • Less sensitive and specific in detecting and diagnosing a vascular abnormality compared with CT imaging.

  • May be subject to motion artifact, susceptibility-weighted artifact, and flow-related artifact.

  • Less adept in detailing the surrounding anatomical structures.

  • Less sensitive and specific in detailing any secondary complications.

VI. What are the contraindications for the alternative imaging techniques?

MRA/MRV imaging

  • Contraindicated in patients with non-MR compatible hardware.

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