Multiparametric Contrast-Free MRI Successfully Identifies Venous Thrombus Responsive to Lytic Therapy: From Mice to Humans

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dc.article.numbere018175
dc.catalogadorgrr
dc.contributor.authorSilickas, Justinas
dc.contributor.authorSmith, Alberto
dc.contributor.authorAndía Kohnenkampf, Marcelo Edgardo
dc.contributor.authorBotnar, René Michael
dc.contributor.authorModarai, Bijan
dc.contributor.authorKarunanithy, Narayan
dc.contributor.authorPatel, Ashish S.
dc.contributor.authorBlack, Stephen
dc.contributor.authorSaha, Prakash
dc.contributor.authorPhinikaridou, Alkystis
dc.date.accessioned2025-11-11T15:32:34Z
dc.date.available2025-11-11T15:32:34Z
dc.date.issued2025
dc.description.abstractBackground:Randomized trials of venous thrombolysis to prevent postthrombotic syndrome have produced mixed results. A method to identify patients most likely to benefit from interventional treatment is needed. This study evaluated a contrast-free, magnetic resonance-based multisequence thrombus imaging (MSTI) technique to characterize deep venous thrombi and predict susceptibility to thrombolysis.Methods:Venous thrombosis was induced in the inferior vena cava of BALB/C mice (n=56, male), which were imaged up to 28 days postsurgery and 24 hours after systemic thrombolysis (Actilyse, 10 mg/kg, IV). The prelysis MSTI protocol included 3-dimensional T1 mapping, 3-dimensional magnetization transfer, and 2-dimensional diffusion-weighted imaging. Thrombolysis was defined as successful if inferior vena cava blood flow increased by ≥50% compared with prelysis values. In a clinical cohort, 41 patients with acute iliofemoral deep venous thrombi underwent MSTI before catheter-directed thrombolysis. Imaging parameters were analyzed against postintervention outcomes.Results:MSTI identified thrombi susceptible to thrombolysis in both mice and humans. In mice, lysed thrombi showed lower T1 (723 [667–782] versus 874 [799–1000] ms; P<0.001) and higher apparent diffusion coefficient values (1.02 [0.96–1.14] versus 0.78 [0.62–0.88]×10-³ mm²/s; P<0.001) than nonlysable thrombi, with no difference in magnetization transfer. In patients, lysed thrombi demonstrated lower T1 (606 [543–656] versus 765 [630–909] ms; P<0.001), lower apparent diffusion coefficient (0.67 [0.5–1.1] versus 1.23 [0.69–1.74]×10-³ mm²/s; P=0.001), and similar magnetization transfer rates. Combining MSTI parameters optimized prediction, achieving 88% sensitivity and 97% specificity in mice, and 86% sensitivity and 91% specificity in humans.Conclusions:MSTI enables noninvasive, contrast-free characterization of thrombus composition and predicts thrombolytic susceptibility. This technique has the potential to guide patient selection for invasive therapies and should be incorporated into future trials of venous thrombosis treatment.
dc.format.extent11 páginas
dc.fuente.origenORCID
dc.identifier.doi10.1161/CIRCIMAGING.125.018175
dc.identifier.eissn1942-0080
dc.identifier.pubmedid41178413
dc.identifier.urihttps://doi.org/10.1161/CIRCIMAGING.125.018175
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/106725
dc.information.autorucEscuela de Ingeniería; Andía Kohnenkampf, Marcelo Edgardo; 0000-0002-1251-5832; 90691
dc.information.autorucInstituto de Ingeniería Biológica y Médica; Botnar, René Michael; 0000-0003-2811-2509; 1015313
dc.language.isoen
dc.nota.accesocontenido parcial
dc.revistaCirculation: Cardiovascular Imaging
dc.rightsacceso abierto
dc.rights.licenseCC BY 4.0 Attribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/deed.es
dc.subjectCatheters
dc.subjectFibrin
dc.subjectLung
dc.subjectPatient selection
dc.subjectVenous thrombosis
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 03 Salud y bienestar
dc.titleMultiparametric Contrast-Free MRI Successfully Identifies Venous Thrombus Responsive to Lytic Therapy: From Mice to Humans
dc.typeartículo
sipa.codpersvinculados90691
sipa.codpersvinculados1015313
sipa.trazabilidadORCID;2025-11-03
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