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We assessed the sensitivity and specificity of diffusion-weighted magnetic resonance imaging (DW-MRI) for the detection of venous thrombosis in the major pelvic vein (PVMV) and of the inferior vena cava (IVC), as determined by using gadolinium as an alternative intravenous contrast agent for venography. DW-MRI was performed in 20 patients in whom 15-ml diluted gadoteridol (Gd-HP-DO3A) was used as an intravenous contrast agent before injecting 40 ml of gadoteridol hydrochloride (Gd-DOTA). The high-resolution 3-dimensional T1-weighted gradient-recalled-echo (GRE) sequences were used as a control for DW-MRI. The results of DW-MRI were compared with those of venography for the presence of PVMV thrombosis and IVC thrombosis. The mean apparent diffusion coefficient (ADC) of PVMV thrombosis was 1.21 +/- 0.33 x 10(-3) mm(2)/sec. The mean ADC of IVC thrombosis was 0.33 +/- 0.07 x 10(-3) mm(2)/sec. The mean ADC of the 20 controls was 1.31 +/- 0.44 x 10(-3) mm(2)/sec (P = 0.0001). In cases with venographically proved PVMV thrombosis, the sensitivity, specificity, and accuracy of DW-MRI were 75%, 90%, and 84%, respectively. For the IVC, the sensitivity, specificity, and accuracy of DW-MRI were 95%, 75%, and 85%, respectively. There was no evidence of a lower sensitivity of DW-MRI than conventional venography, but rather, there was an increased specificity in IVC cases that were previously considered
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