A Novel Scoring System for Lower-extremity Venous Pathology Analysed Using Magnetic Resonance Venography and Duplex Ultrasound

Objectives: To present a novel scoring system for lower-extremity venous pathology (the LOVE score) and our experiences using it in our clinical practice to identify venous pathology with duplex ultrasound (DUS) and magnetic resonance venography (MRV). Method: A total of 40 patients, 30 suspected of chronic venous disease and 10 with acute deep vein thrombosis (DVT) were examined from the inferior vena cava (IVC) to the popliteal vein using DUS and MRV. The image findings were reported using the LOVE score. Results The majority of deep veins (368 out of 378 segments) were completely visualized by both our imaging techniques and could be analysed using the LOVE score. Both imaging techniques reported comparable findings with regard to the visualization of thrombus, obstruction, collaterals, trabeculations, anatomic variations and central venous compression (e.g. May-Thurner). Conclusions: The LOVE score can be used to expand and standardize the documentation of imaging the deep venous system beyond thrombosis, to help identify (optimal) treatment options in patients with venous disease, in both the clinical and research setting. This first assessment shows that both DUS and MRV are capable of systematically identifying a multitude of changes in the venous system.