Molecular Magnetic Resonance Imaging of Deep Vein Thrombosis Using a Fibrin-Targeted Contrast Agent: A Feasibility Study

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Purpose:To evaluate the value of a fibrin-specific MR contrast agent (EP-2104R; EPIX Pharmaceuticals) for detection of deep vein thrombosis (DVT) and monitoring of percutaneous intervention for treatment.Materials and Methods:In 6 domestic swine, DVT was induced in an iliac/femoral vein using an occlusion-balloon catheter and subsequent injection of thrombin. The occluded vessels were recanalized by mechanical thrombectomy using a Fogarty catheter and an Arrow rotating thrombectomy device. Magnetic resonance imaging of the pelvis and lung was repeated 4 times (before and after DVT induction, after contrast agent administration, and after intervention) using a 1.5-T whole-body XMR system (ACS-NT, Philips Medical Systems, Best, NL). The visualization of the thrombi and contrast-to-noise ratio (CNR) was assessed.Results:EP-2104R allowed selective visualization of thrombi with accurate determination of the extent of DVT with high contrast (CNR: 65.3 ± 17.2). After intervention, dislodged thrombus fragments were selectively visualized in the lung (CNR: 27.9 ± 9.3).Conclusions:Molecular magnetic resonance imaging using fibrin-specific MR contrast agent EP-2104R allowed for selective visualization of DVT and monitoring of percutaneous intervention.

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