Retrospective Assessment of the Utility of an Iron-Based Agent for Contrast-Enhanced Magnetic Resonance Venography In Patients With Endstage Renal Diseases

Purpose: To compare abdominopelvic and lower extremity venous enhancement in contrast-enhanced magnetic resonance venography (ceMRV), using iron-based ferumoxytol and gadolinium-based gadofosveset. Materials and Methods: This was a Health Insurance Portability and Accountability Act (HIPAA)-compliant retrospective study. Thirty-four patients were identified who had undergone ceMRV using either ferumoxtyol (Group A, all with chronic renal insufficiency) or gadofosveset (Group B). Two radiologists rated confidence for evaluation of the major abdominopelvic and lower extremity veins from 4 (excellent confidence) to 1 (nondiagnostic). A third radiologist measured signal intensity ratios (SIRs) of venous segments compared with adjacent muscles. Scores were compared using repeated-measures analysis of variance (ANOVA). The medical record was searched for contemporaneous imaging to confirm the ceMRV findings. Results: In Group A, 14/225 venous segments were thrombosed, compared with 18/282 in Group B. There was no statistically significant difference between confidence scores (3.79 +/- 0.44 vs. 3.85 +/- 0.44, P = 0.34) or SIRs (2.40 +/- 0.73 vs. 2.38 +/- 0.51, P = 0.51) for patent segments in the two groups, nor were confidences scores (3.89 +/- 0.29 vs. 3.72 +/- 0.46, P = 0.31) or SIRs (0.90 +/- 0.12 vs. 0.84 +/- 0.19, P = 0.31) significantly different for thrombosed segments. Contemporaneous imaging confirmed ceMRV findings in 227 segments. Conclusion: ceMRV can be performed with ferumoxytol, yielding similar image quality to a blood pool gadolinium-based contrast agent.