Leiden University Scholarly Publications

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Dam, L.F. van (2022)

Novel imaging strategies in venous thromboembolism

Doctoral Thesis
Venous thromboembolism (VTE) encompasses pulmonary embolism (PE) and deep vein thrombosis (DVT). DVT most commonly occurs in the deep veins of the lower extremity but can also occur in the veins of upper extremity, abdomen and cerebrum. As symptoms of VTE are nonspecific, the diagnosis of VTE is based on diagnostic tests, including clinical decision rules (CDR), D-dimer tests and imaging. Although the diagnostic management of VTE has greatly advanced in recent years with the introduction of novel CDRs and high-sensitive D-dimer tests, the diagnosis may still be challenging in certain settings. The latter is mainly caused by the indirect way of thrombus visualisation by current imaging tests, such as by showing incompressibility with compression ultrasonography (CUS) or a filling defect on contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI).
This thesis focuses on challenging settings for diagnosing VTE, including suspected recurrent ipsilateral DVT,...Show moreVenous thromboembolism (VTE) encompasses pulmonary embolism (PE) and deep vein thrombosis (DVT). DVT most commonly occurs in the deep veins of the lower extremity but can also occur in the veins of upper extremity, abdomen and cerebrum. As symptoms of VTE are nonspecific, the diagnosis of VTE is based on diagnostic tests, including clinical decision rules (CDR), D-dimer tests and imaging. Although the diagnostic management of VTE has greatly advanced in recent years with the introduction of novel CDRs and high-sensitive D-dimer tests, the diagnosis may still be challenging in certain settings. The latter is mainly caused by the indirect way of thrombus visualisation by current imaging tests, such as by showing incompressibility with compression ultrasonography (CUS) or a filling defect on contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI).
This thesis focuses on challenging settings for diagnosing VTE, including suspected recurrent ipsilateral DVT, upper extremity DVT, cerebral vein thrombosis and portal vein thrombosis. We studied a novel imaging technique called Magnetic Resonance Non-Contrast Thrombus Imaging (MR-NCTI) and its application in these different VTE settings.
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Venous thromboembolism
Deep vein thrombosis
Imaging
Diagnosis
Diagnostic management
Pulmonary embolism
MRI
Computed tomography
Ultrasonography
All authors
Dam, L.F. van
Supervisor
Huisman, M.V.
Co-supervisor
Klok, F.A.
Committee
Eikenboom, H.C.J.; Leebeek, F.W.G.; Meijer, K.; Cate-Hoek, A. ten
Qualification
Doctor (dr.)
Awarding Institution
Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
Date
2022-01-27
ISBN (print)
9789464167375

Funding

Sponsorship
Dutch Heart Foundation, LEO Pharma B.V., Bayer Healthcare B.V., Federatie van Nederlandse Trombosediensten, STAGO B.V., Boehringer-Ingelheim B.V., Chipsoft anf, Nederlandse Vereniging voor Spoedeisende Hulp Artsen (NVSHA)