Retrospective analysis of hematocrit effect and vein diameter in plantar veins in magnetic resonance imaging in terms of venous insufficiency and correlation with doppler ultrasound findings

When the blood stagnates, the separation of its celular elements and plasma from each other is called the hematocrit effect and can be observed as liquid-liquid leveling in cross-sectional imaging. There are few studies in the literature about the radiological meaning of this phenomenon and its relationship with any pathology has not been defined yet. Our study tries to reveal the relationship of this phenomenon, which we can see in MR images of plantar veins, with plantar venous insufficiency, taking into account the diameter of the vein. In our study, a total of 121 patients, who underwent both ankle magnetic resonance imaging and lower extremity venous doppler ultrasound examination for venous insufficiency, were analyzed retrospectively in the Radiology Department of Akdeniz University Medical Faculty Hospital between 2015 and 2020. In patients with more than one magnetic resonance or ultrasound examination, examinations with the closest dates were included in the study. It was found that the incidence of hematocrit effect in plantar veins did not change with age, gender and laterality, but it was more common in patients with positive doppler ultrasound findings in terms of insufficiency. In addition, our study showed that the diameters of the plantar veins with hematocrit effect are larger. According to the results of our study, the phenomenon of hematocrit effect observed in plantar veins has the potential to be a radiological biomarker for lower extremity venous insufficiency. When reporting this finding, it should be kept in mind that it may be associated with venous insufficiency. However, since there was no correlation with clinical findings in our study, it is necessary to be cautious when associating this finding with the diagnosis of chronic venous disease in which clinical findings already have a very important place. Prospective studies are also needed to demonstrate the utility of the hematocrit effect phenomenon in the early diagnosis of lower extremity venous insufficiency.