Case Reports

CMagnetic resonance venography in assessing venous recanalization after catheter-related thrombosis

Sachiko Sakai, Takako Nishina, Takatsugu Murakoshi, Mari Arai
Department of Surgery, Tokyo Metropolitan Hachioji Children’s Hospital
（Tokyo Metropolitan Children’s Medical Center）

Abstract

　　In children who require long-term parenteral nutrition（PN）, venous occlusion due to catheter-related thrombosis often precludes repeated central venous access. We describe our experience with 2 children who were receiving long-term PN through a central venous catheter（CVC）and underwent magnetic resonance venography（MRV）to accurately identify sites of venous recanalization that had previously been occluded.
The first patient was a 7−year−old boy with fat malabsorption. He regularly required intravenous infusions of fat emulsion and multivitamins. Patent veins gradually became hard to identify, and MRV was performed. Recanalization of the right internal jugular vein was confirmed, allowing placement of a CVC.
The second patient was a 9−year−old boy with short bowel syndrome, who had needed long−term PN through a CVC. With growth, we had to find a new route because of depletion of the appropriate CV route, and MRV was performed. Recanalization of the left internal jugular vein was confirmed, enabling CVC placement.
The reproducibility of MRV is higher than that of ultrasonography and conventional venography, and the procedure is minimally invasive. MRV is considered very useful for identifying recanalized veins for reinsertion of a CVC in patients with venous occlusion associated with long-term PN.

Keywords：MRV, CV catheter, Venous recanalization