Assessing Different Imaging Modalities for the Diagnosis of MayThurner Syndrome: A Review
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 5
Abstract
May-Thurner Syndrome(MTS) is a type of venous compression syndrome typically characterized by the compression of left common iliac vein by the overlying right common iliac artery and the fifth lumbar vertebra causing venous obstruction, venous insufficiency, and left lower extremity deep vein thrombosis. The diagnosis is based on clinical presentations and imaging. This review article gives a brief summary on different imaging modalities that are used to diagnose MTS. The initial diagnostic workup is the doppler ultrasound which can easily detect lower extremity deep vein thrombosis (DVT)but doesn’t give clear information about the venous abnormalities or any anatomic changes in the pelvic area. Both Computed Tomography (CT) venography and Magnetic Resonance (MR) venography can give a clear picture of the veins in the abdomen and the pelvis and can assess any extrinsic compression, degree of stenosis, and underlying thrombosis. Unlike CT venography, MR venography has minimum risk of ionizing radiation exposure and can be used to detect venous flow direction helping in detecting the hemodynamic consequences; it can also be used without contrast agent in allergic and renal failure patients. Catheter directed contrast venography is the gold standard for the diagnosis of MTS; distinguishing acute or chronic thrombus, detecting collaterals, associated venous obstruction, and degree of stenosis. Intravascular ultrasound is evolving as the dynamic tool which identifies early intimal changes and precisely measures venous narrowing. Endovascular treatment with balloon angioplasty or stenting can also be planned in a single setting when diagnosing suspected MTS with contrast venography or intravascular ultrasound.
Authors and Affiliations
Mohammed Jameeluddin Ahmed, Mustafa Razi, Xu He, Jian-Ping Gu
Keywords
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- EP ID EP375174
- DOI 10.9790/0853-1705105763.
- Views 56
- Downloads 0
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