Postpartum Right Pelvic and Deep Venous Thrombosis
Clinical details
27 year-old patient with hereditary protein C deficiency and postpartum deep venous thrombosis in the right leg.
Summary of findings and diagnosis
Complete thrombotic occlusion of the infrarenal inferior vena cava. Pelvic and bilateral deep venous thrombosis on the lower extremities due to established hereditary protein C deficiency.
Description of images
[1] MR angiography of the pelvis and leg (T1 3D FFE with Gadofosveset) in first-pass. MIP from suprarenal level to lower leg. No evidence of relevant arterial stenoses.
[2] Higher resolution coronary steady-state image of the abdominal and pelvic vessels. A thrombus completely occludes the infrarenal inferior caval vein (arrow). Pronounced collateralization above the left ovarian vein (arrowhead).
[3] Curved Multiplanar Reformation (curved MPR) of a high-resolution steady-state image of abdominal and pelvic vessels for better imaging of the anatomical course of the right pelvic blood stream. The thrombosis of the inferior caval vein continues in the pelvic blood stream.
[4] Maximum Intensity Projection (MIP) of subtracted high-resolution steady-state images of the femoral vessels. Complete thrombosis of the right superficial femoral vein, which is not imaged. The left Superficial femoral vein is also completely thrombotic from the mid third of the upper leg (arrow). The superficial veins and great saphenous vein are extensively perfused on both sides.
[5] Coronary MPR of a contrast agent enhanced CT of the same patient. The procedure was conducted as part of a diagnosis to exclude a lung embolism. The diagnosis made from the MR angiography of a thrombosis of the Inferior caval vein was hereby confirmed (arrows).
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