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Vascular and Interventional Radiology |
1 Department of Radiology, Sir Charles Gairdner Hospital, Queen Elizabeth II Medical Centre, Verdun St, Nedlands 6009, Western Australia.
PURPOSE: To prospectively evaluate pulmonary magnetic resonance (MR) angiography as a diagnostic examination for acute pulmonary embolism (PE).
MATERIALS AND METHODS: Thirty-six consecutive patients (19 women, 17 men; age range, 28–84 years) underwent pulmonary digital subtraction angiography (DSA) and pulmonary MR angiography. MR angiograms were obtained during suspended respiration and the pulmonary arterial phase of a gadolinium-based contrast medium injection. A steady-state gradient-recalled-echo sequence with free induction decay sampling was used. DSA studies were interpreted for the presence of acute PE by two independent radiologists; an adjudicator made the final decision on discordant interpretations.
RESULTS: By using DSA, a total of 19 acute pulmonary emboli were depicted in 13 patients. Prospectively, 13 of these emboli were depicted by using MR angiography. MR angiography missed six emboli: Four required the DSA adjudicator to make the decision, and one was in a patient whose MR angiogram was acquired during breathing. Four of these six emboli were small subsegmental emboli, and two were segmental.
CONCLUSION: Performed without pulmonary arterial catheterization, iodinated contrast media, or ionizing radiation, pulmonary MR angiography had a high accuracy for depicting lobar and segmental emboli, but was unable to depict four of five subsegmental emboli.
Index terms: Embolism, pulmonary, 564.783, 944.77 • Magnetic resonance (MR), angiography, 564.12142, 944.12942 • Magnetic resonance (MR), comparative studies • Pulmonary angiography, 564.12142, 564.124, 944.1222, 944.12942 • Pulmonary arteries, stenosis or obstruction, 564.783, 944.77
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