MR venography The Phlebology Clinic / Services / Venography / MR venography Introduction Scope of service Preparation Specialists Frequently asked questions Introduction Magnetic resonance venography (magnetic resonance venography, MRV) is an advanced venous imaging technique that uses a magnetic field and radio waves to obtain detailed images of the venous system. In the Department of Phlebology, we classify it as a so-called 'magnetic resonance venography'. enhanced diagnostics. We always use it after an initial or comprehensive ultrasound assessment of the venous system (Doppler ultrasound). Only this approach (a combination of the two methods) gives a reliable picture of the pathology of the venous system. This examination allows a precise assessment of the condition of the venous vessels in areas difficult to access with standard Doppler ultrasound, particularly in the pelvic and abdominal regions. However, it is important to note that MRV examination has several significant disadvantages. It is a long examination, usually taking about 45-55 minutes, difficult to perform and difficult to assess (this is where most errors occur!). Magnetic resonance imaging, particularly venography, is an examination that is very prone to artefacts. Therefore, cooperation on the part of the Patient is crucial here. And importantly, the position of the Patient during the examination itself (supine) does not fully reflect the correct conditions of the venous system. Often, incorrect decisions about the treatment strategy are made after MR venography alone (without a prior comprehensive venous ultrasound examination). Modern venography should be performed using high-field resonances (with a field strength of 3T). This ensures the highest imaging quality and adequate diagnostic accuracy. In contrast to classic phlebography, MR venography is a much less invasive examination, requiring only the intravenous administration of a small amount of gadolinium contrast agent. Advantages of MR venography imaging imaging without the use of ionising radiation; large field of view to assess extensive anatomical areas; high soft tissue contrast without the need to administer contrast agents (however, the examination itself is performed with the administration of gadolinium contrast agent intravenously); low dose of intravenous contrast; various imaging sequences can be used in a single examination (big advantage over CT): evaluation of blood flow without contrast agent, quantitative evaluation of contrast dynamics, 2D and 3D imaging with high resolution, multiphase and dynamic imaging of the rate of vascular contrast after contrast agent administration, possible separation of fat and water signal, imaging to visualise vessel wall structure and post-thrombotic changes in the vessel lumen; precise assessment of venous anatomy and morphology (key in the diagnosis of venous anomalies); the possibility of excluding other pathologies such as endometriosis and its intrauterine form (adenomyosis), adhesions in the small pelvis and abdominal cavity, focal lesions in the small pelvis, neoplastic lesions, enlarged lymph nodes, aneurysms, etc. in urgent and life-threatening cases, the possibility of testing pregnant women. Indications for MR venography In the Department of Phlebology MR venography study is most commonly performed in the following diseases and clinical situations: pelvic venous insufficiency; Venous compression phenomena in the abdominal and pelvic cavities; Imaging of venous anomalies in the abdomen and pelvis; imaging of organ anomalies associated with vascular malformations (including venous vessels); symptomatic varicose veins of the intimate area; assessment of post-thrombotic changes in abdominal and pelvic veins; diagnosis of vascular malformations, including complex venous malformations; diagnosis of arteriovenous fistulas; intravenous treatment planning. Patient preparation for MR venography examination In order to proceed with the MR venography commissioned by the specialists at the Department of Phlebology and for it to come out optimally diagnostically, several conditions must be met: Arrive at the Imaging Diagnostics Registration Desk approximately 20 minutes before the examination; on the day of the examination, be sure to bring a referral issued by a phlebologist from the Phlebology Clinic (the examination will not be performed without a referral); before insertion of the venepuncture, show the MR Laboratory nurse the result of a blood creatinine level test (we honour determinations made no later than 14 days before the examination); arrive on an empty stomach for the examination (please do not eat until 4-6 hours before the examination); start hydrating as early as 2 days before the examination (consume up to 2.5 litres of still water per day); take a tablet of No-Spa (20 mg) on the day before the examination - preferably the evening before the examination and the same dose on the morning of the examination; immediately before the venography test, go to the toilet to empty the bladder; provide the examining staff with previous imaging documentation (CD/DVD) and descriptions of gynaecological and vascular procedures or operations. Course of the MR venography study Study MR venography ordered at the Phlebology Clinic is carried out in the Imaging Diagnostic Laboratory of the Sports Medicine Centre by a radiology technician - always under the supervision of a radiologist and a nurse. The examination is performed on a modern scanner 3T from Philips. The examination takes approximately 45-55 minutes. The entire procedure includes: completion of a detailed medical questionnaire assigned to the MR Laboratory conditions (this activity should be performed at least 15-20 minutes before the examination); verification of creatinine results; analysis of possible contraindications to MR examination; leaving all metal objects in the changing room and changing into disposable clothing provided by the medical staff in the MR Laboratory; insertion of a venepuncture (necessary for the administration of contrast media); emptying the bladder just before the examination; Positioning of the patient on the MR apparatus table by the radiology technician performing the examination (MR venography examinations are usually performed in the supine position); insertion of a receiving coil in the pelvic and abdominal area; explanation of the examination by the radiology technician; Wearing headphones to protect against the noise inherent in the MR examination; the first part of the examination is carried out non-contrast; The second phase of the examination is carried out after the contrast medium has been injected via an automatic syringe (scanning from the moment of contrast injection takes approximately 10-15 minutes); The control of the patient's wellbeing during and after the administration of the contrast agent usually lasts up to 30-40 minutes after administration; removal of the venflon and application of a small dressing at the insertion site. Make an appointment Why is an MR venography test worth performing under the guidance of the specialists at the Phlebology Clinic? We have the most experience in Poland in the diagnosis of the venous system by MR venography; MRV examinations are performed on 3 Tesla (high-field) instruments as part of a proprietary diagnostic pathway and our proprietary diagnostic protocol; diagnostic and therapeutic efficacy has been confirmed by more than 10 years of observations and scientific studies; we are the authors of our own radiological-haemodynamic classification of pelvic venous insufficiency; we have a team of experienced doctors specialising in radiology and diagnostic imaging, phlebology, interventional radiology, surgery and vascular surgery. Consulting specialists dr n. med. Cezary Szary - phlebologist, radiologist Phlebology, Radiology and Imaging Diagnostics Dr Dominika Plucińska - phlebologist, radiologist radiology and diagnostic imaging, phlebology Tomasz Grzela, MD - phlebologist, surgeon General surgery, phlebology dr n. med. Jerzy Leszczyński - vascular surgeon General surgery, vascular surgery dr n. med. Justyna Wilczko – flebolog, internista Phlebology, internal medicine, radiology and diagnostic imaging Dr Krzysztof Celejewski - phlebologist, surgeon general surgery, phlebology dr n. med. Łodyga Małgorzata - phlebologist, cardiologist cardiology, phlebology, Doppler ultrasonography Dr Marcin Napierała - phlebologist, surgeon general surgery, phlebology Mostlyquestions asked Is MR venography safe in pregnancy? Research MR venography is not performed in women in the first trimester of pregnancy. In other cases, the decision is made by the doctor. During pregnancy - if there is a need to examine the venous system of the mother-to-be - we usually opt for a Doppler ultrasound examination of the venous system. Is the MR venography examination painful? No, the examination is virtually painless. The only discomfort for the patient may be the moment of insertion of the venflon (intravenous insertion) prior to the examination and the temporary sensations during phase II of the examination, resulting from the intravenous administration of the contrast agent. Is it possible to return to daily activities immediately after MR venography? Yes, immediately after the 30-minute observation following the administration of the contrast agent, you can return to your normal activities. For 24 hours after the examination, we recommend taking increased amounts of fluids (still water) to accelerate the excretion of the contrast agent from the body. In the absence of complications (usually simple allergic reactions), there are no contraindications to driving or returning to work. Is it possible to breathe normally during MR venography? Yes, you can breathe freely during most of the examination. During some sequences, the patient is asked to hold his/her breath for a few seconds or so. Can medications be taken prior to MR venography? Most medications can be taken normally before the MR venography examination. If in doubt, consult the doctor ordering the examination. Dr Venus: virtual patient counsellor Are you looking for an answer to your question about diagnostic vein imaging? Ask our Dr Venus! Ask Dr Venus a question Can endometriosis and veins be diagnosed by MR examination? Yes, MRI is very useful in the diagnosis of endometriosis and the evaluation of the venous system. If endometriosis is suspected, the MR examination allows an accurate assessment of endometrial lesions, which often coexist with pelvic venous insufficiency. 01 / Vascular spider veins Dilated subcutaneous capillaries and reticular veins are a common symptom heralding the development of venous insufficiency. Their occurrence should not be underestimated. 02 / Varicose veins of the lower limbs They are the most common symptom of venous insufficiency of the lower limbs. Their occurrence should not be underestimated. At the Phlebology Clinic, we treat venous disease causally. 03 / Venous edema of the shin An enlargement of the shin circumference that increases in the evening, accompanied by a feeling of heaviness, is usually a symptom of venous insufficiency. Think about having a venous Doppler ultrasound examination! 04 / Pelvic venous insufficiency Painful and prolonged periods, heaviness in the legs during menstruation, pain during intercourse and burning in the intimate area are just some of the symptoms of pelvic venous insufficiency. Find out more! 05 / Venous compression syndromes It is a group of anatomically determined venous disorders leading to early onset of pelvic venous insufficiency and varicose veins on the legs. It affects both ladies and gentlemen! 06 / Venous disease in pregnancy Not sure when to start wearing compression stockings? Do you suspect vulvar varicose veins or have noticed sudden swelling of a limb during pregnancy! Don't wait to develop venous disease - consult our phlebologist for your symptoms. 07 / Varicose veins of the spermatic cord Up to 40% cases of male infertility may be related to varicose veins of the seminal vagina. This form of pelvic venous insufficiency is one of the more common causes of varicose veins on the legs and a cause of discomfort in the groin and scrotum. Early diagnosis increases the chance of a full cure! 08 / Venous thrombosis Swelling of the leg, pain and redness are alarm signals that should not be ignored. Venous thrombosis is an emergency condition that requires immediate diagnosis by Doppler ultrasound. If untreated, it can lead to life-threatening pulmonary embolism. 01 / 08 Modern vein treatment We offer treatment both on an outpatient basis and in day ward admissions. The stay is of short duration. The patient spends between 1 and 5 hours in the Clinic. Make an appointment Make an appointment at the Phlebology Clinic Give us a call!
