Evidence map›Paper›PMID 34018662›Full record

ArticleJournal of thrombosis and haemostasis : JTH2021

Detection of upper extremity deep vein thrombosis by magnetic resonance non-contrast thrombus imaging.

Lisette F van Dam, Charlotte E A Dronkers, Gargi Gautam, Åsa Eckerbom, Waleed Ghanima, Jostein Gleditsch, Guido R van Haren, Anders von Heijne, Menno V Huisman, J Lauran Stöger and 3 more

Open access · hybridAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of thrombosis and haemostasis : JTH, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Guideline
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 3 countries.

Lisette F van DamDepartment of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands.
Charlotte E A DronkersDepartment of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands.
Gargi GautamDepartment of Clinical Sciences, Karolinska Institute, Danderyd Hospital, Stockholm, Sweden.
Åsa EckerbomDepartment of Clinical Sciences, Karolinska Institute, Danderyd Hospital, Stockholm, Sweden.
Waleed GhanimaInternal Medicine Clinic, Østfold Hospital Trust, Østfold, Norway.
Jostein GleditschDepartment of Radiology, Østfold Hospital Trust, Østfold, Norway.
Guido R van HarenDepartment of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Anders von HeijneDepartment of Clinical Sciences, Karolinska Institute, Danderyd Hospital, Stockholm, Sweden.
Menno V HuismanDepartment of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands.
J Lauran StögerDepartment of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Eli WesterlundDepartment of Clinical Sciences, Karolinska Institute, Danderyd Hospital, Stockholm, Sweden.
Lucia J M KroftDepartment of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Frederikus A KlokDepartment of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands.
Leiden University Medical Center · NLKarolinska Institutet · SEOslo University Hospital · NOØstfold Hospital Trust · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCompression ultrasonography (CUS) is the first-line imaging test for diagnosing upper extremity deep vein thrombosis (UEDVT), but often yields inconclusive test results. Contrast venography is still considered the diagnostic standard but is an invasive technique.

objectivesWe aimed to determine the diagnostic accuracy of magnetic resonance noncontrast thrombus imaging (MR-NCTI) for the diagnosis of UEDVT.

methodsIn this international multicenter diagnostic study, we prospectively included patients with clinically suspected UEDVT who were managed according to a diagnostic algorithm that included a clinical decision rule (CDR), D-dimer test, and diagnostic imaging. UEDVT was confirmed by CUS or (computed tomography [CT]) venography. UEDVT was excluded by (1) an unlikely CDR and normal D-dimer, (2) a normal serial CUS or (3) a normal (CT) venography. Within 48 h after the final diagnosis was established, patients underwent MR-NCTI. MR-NCTI images were assessed post hoc by two independent radiologists unaware of the presence or absence of UEDVT. The sensitivity, specificity, and interobserver agreement of MR-NCTI for UEDVT were determined.

resultsMagnetic resonance noncontrast thrombus imaging demonstrated UEDVT in 28 of 30 patients with UEDVT and was normal in all 30 patients where UEDVT was ruled out, yielding a sensitivity of 93% (95% CI 78-99) and specificity of 100% (95% CI 88-100). The interobserver agreement of MR-NCTI had a kappa value of 0.83 (95% CI 0.69-0.97).

conclusionsMagnetic resonance noncontrast thrombus imaging is an accurate and reproducible method for diagnosing UEDVT. Clinical outcome studies should determine whether MR-NCTI can replace venography as the second-line imaging test in case of inconclusive CUS.

Indexed as

Upper Extremity Deep Vein ThrombosisHumansMagnetic Resonance ImagingMagnetic Resonance SpectroscopyPhlebographyUltrasonographyUpper Extremityanticoagulationdeep vein thrombosisdiagnosisdiagnostic imagingmagnetic resonance imaging

Identifiers

PMID34018662
PMCPMC8361740
OpenAlexW3160507069

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.