Reason: MRV - Eval lower extremity venous structures for patency distal iliac to femoral-saphenous junction History: ex preemie, immunodeficiency, infected central line RLEEXAMINATION: MRI of the pelvis was performed before and after the administration of 2 mL of gadolinium. Postcontrast MRA/MRV sequences were obtained. Additional 3-D reformatted images generated on a separate workstation are also provided for interpretation. MRA: The aorta, iliac arteries, common femoral arteries, and proximal popliteal arteries are patent. The deep femoral arteries are not well visualized beyond the most proximal portion.MRV: The right common iliac and external iliac veins are patent but are small in caliber. No common femoral vein is visualized on the right, there are however multiple small/discontinuous collateral vessels in the right thigh. There is an apparent tangle of vessels in the right pelvis, likely representing collateral venous drainage from the right leg (series 1101, image 65). There are prominent lumbar veins which likely provide the majority of the drainage from the right lower extremity as the right common iliac vein upstream to this point is markedly attenuated (series 1101, image 29), which may be secondary to slow flow in the IVC related to the indwelling catheter.A catheter is present in the left femoral vein which extends into the IVC, terminating cranially out of the field of view. The rate of flow cannot be well assessed given the presence of the catheter. There is mural thickening of the visualized left lower extremity veins suggesting inflammation/scarring, which may be related to long-standing catheterization.MRI: Postsurgical changes in the abdomen are noted, including a ventral abdominal wall defect.
1.Nonvisualization of the right common femoral vein with multiple small and discontinuous collaterals in the right thigh.2.Attenuation of the right common iliac vein, with an enlarged lumbar venous system, which is likely providing the majority of venous drainage from the right lower extremity.3.Mural thickening of the left common iliac and femoral veins suggesting inflammation/scarring secondary to long-standing catheterization.