Advanced MRI technology visualizing blood vessels

Unclogging the Mystery: Can New Imaging Techniques Revolutionize DVT Treatment?

Lena Kashyap in Health & Wellness December 2025 • 4 min read.

"Innovative MRI Technology Offers Hope for Predicting Thrombus Lysability and Personalized Treatment Strategies"

Deep vein thrombosis (DVT) is a serious condition where blood clots form in the deep veins of the body, most commonly in the legs. Acute iliofemoral DVT, specifically, affects the large veins in the pelvis and thigh, and can lead to significant long-term complications like post-thrombotic syndrome (PTS). PTS occurs when the valves in the veins are damaged by the clot, leading to chronic pain, swelling, and skin changes.

Catheter-directed thrombolysis (CDT) is a treatment option aimed at dissolving the blood clot and restoring normal blood flow. However, CDT isn't always successful, and it carries a risk of bleeding complications. Determining which patients are most likely to benefit from CDT, while minimizing risks, remains a challenge for vascular specialists.

Now, a new study presented at the 19th Meeting of the European Venous Forum offers a promising solution. Researchers explored the use of magnetic resonance multi-sequence thrombus imaging (MSTI) as a non-invasive way to assess the characteristics of blood clots and predict their response to thrombolysis. This innovative approach could potentially revolutionize DVT treatment by allowing for more personalized and effective interventions.

MSTI: A New Window into Thrombus Composition

Advanced MRI technology visualizing blood vessels

The study, led by Justinas Silickas and colleagues from King's College London, involved 39 patients with acute iliofemoral DVT. Each patient underwent MSTI prior to CDT. This specialized MRI technique uses multiple sequences to gather detailed information about the thrombus, including:

T1 Mapping: Measures the relaxation times of water molecules within the thrombus, providing insights into its age and composition.

Magnetization Transfer: Assesses the interactions between water molecules and macromolecules like fibrin within the clot.
Diffusion-Weighted Imaging: Measures the movement of water molecules, reflecting the density and structure of the thrombus.

By analyzing these parameters, the researchers aimed to identify markers that could predict the success of thrombolysis.

The Future of DVT Treatment: Personalized and Precise

This study offers a glimpse into a future where DVT treatment is tailored to the individual characteristics of each patient's thrombus. By using MSTI to predict thrombus lysability, clinicians can make more informed decisions about the use of CDT, potentially improving outcomes and minimizing the risk of complications. While further research is needed to optimize image analysis methods and validate these findings across different centers, MSTI holds great promise as a valuable tool in the fight against DVT and its debilitating consequences.

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Everything You Need To Know

What is Deep Vein Thrombosis (DVT), and why is Acute Iliofemoral DVT particularly concerning?

Deep Vein Thrombosis (DVT) is a serious medical condition that arises when blood clots form in the deep veins of the body, typically in the legs. Acute iliofemoral DVT, in particular, affects the large veins in the pelvis and thigh. This is concerning because it can lead to significant long-term complications, most notably post-thrombotic syndrome (PTS). PTS can cause chronic pain, swelling, and skin changes due to damage to the valves in the veins caused by the initial blood clot.

What is Catheter-Directed Thrombolysis (CDT), and what are its limitations in treating DVT?

Catheter-Directed Thrombolysis (CDT) is a treatment option for DVT that aims to dissolve blood clots and restore normal blood flow. While CDT can be effective, it's not always successful, and it carries inherent risks, including bleeding complications. The major limitation is the inability to predict with certainty which patients will benefit most from CDT, which is why vascular specialists seek tools to personalize treatment and minimize risk.

How does Magnetic Resonance Multi-sequence Thrombus Imaging (MSTI) work, and what information does it provide?

Magnetic Resonance Multi-sequence Thrombus Imaging (MSTI) is a specialized MRI technique that uses multiple sequences to gather detailed information about the blood clot (thrombus). MSTI includes: T1 Mapping, which measures the relaxation times of water molecules within the thrombus to assess its age and composition. Magnetization Transfer, which assesses the interactions between water molecules and macromolecules like fibrin within the clot. Diffusion-Weighted Imaging, which measures the movement of water molecules, reflecting the density and structure of the thrombus. By analyzing these parameters, researchers aim to identify markers that predict the success of thrombolysis.

How can MSTI potentially revolutionize the treatment of Deep Vein Thrombosis?

MSTI has the potential to revolutionize DVT treatment by enabling more personalized and effective interventions. By using MSTI to predict the thrombus lysability (how easily a clot can be dissolved), clinicians can make more informed decisions about the use of CDT. This could lead to improved patient outcomes by ensuring that patients most likely to benefit from CDT receive the treatment while minimizing unnecessary risks for others. This approach represents a shift towards tailored DVT treatment.

What are the next steps for MSTI research and implementation in DVT treatment?

While the study provides promising results, further research is needed to optimize image analysis methods and validate these findings across different medical centers. This includes refining the MSTI technique itself, correlating imaging findings with clinical outcomes, and establishing standardized protocols for image interpretation. The goal is to integrate MSTI into clinical practice, allowing vascular specialists to make more informed decisions and improve patient care in the fight against DVT and its debilitating consequences. Further studies will also help to understand how the composition of a thrombus, as revealed by MSTI, affects its response to other treatments besides CDT.