Detection of pulmonary embolism with free-breathing dynamic contrast-enhanced MRI

Ingrisch, Michael; Maxien, Daniel; Meinel, Felix G.; Reiser, Maximilian; Nikolaou, Konstantin; Dietrich, Olaf

doi:10.1002/jmri.25050

Cited by 12 publications

(7 citation statements)

References 29 publications

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“…In addition to that, free‐breathing techniques are desirable in patients with impaired lung function. Recently, the feasibility of DCE‐MRI in free breathing was demonstrated in healthy volunteers and patients with acute pulmonary embolism . Although these results are promising, DCE‐MRI is performed with a breath‐hold at most sites.…”

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confidence: 99%

Comparison of quantitative regional perfusion‐weighted phase resolved functional lung (PREFUL) MRI with dynamic gadolinium‐enhanced regional pulmonary perfusion MRI in COPD patients

Kaireit

Voskrebenzev

Gutberlet

et al. 2018

Magnetic Resonance Imaging

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Background: Perfusion-weighted noncontrast-enhanced proton lung MRI during free breathing is maturing as a novel technique for assessment of regional lung perfusion, but has not yet been validated in chronic obstructive pulmonary disease (COPD) patients. Purpose: To compare pulmonary parenchymal perfusion assessed by noncontrast-enhanced perfusion-weighted phaseresolved functional lung (PREFUL)-MRI with lung perfusion determined with dynamic gadolinium-enhanced (DCE)-MRI and with lung function test parameters. Study Type: Prospective. Population: A single-center subset of the COPD cohort "COPD and SYstemic consequenzes-COmorbidities NETwork" (COSYCONET). Forty-seven patients with COPD (median age 66 [57-70] years) were studied. Field Strength/Sequence: For PREFUL-MRI a spoiled gradient echo sequence and for DCE-MRI, a 3D time-resolved spoiled gradient echo sequence was used at 1.5T. Assessment: PREFUL-MRI coronal slices were acquired in free breathing. DCE-MRI was performed in breath-hold with administration of 0.025 mmol/kg bodyweight of gadobutrol i.v. at a rate of 4 ml/s and pulmonary blood flow (PBF) maps were calculated. Slices of PREFUL and DCE-MRI were matched by their ventrodorsal position and corresponding slices were coregistered for evaluation. Perfusion defect percentages (QDP) were calculated for both methods. Statistical Tests: The obtained parameters were correlated using Spearman's correlation coefficient (r) and Bland-Altman plot analysis. Results: PREFUL-QDP showed an absolute and spatial agreement with PBF-QDP on a global (39.3 (31.8-45.5)% vs. 44.7 (35.4-50.0)% with a spatial overlap of 62.2 (57.2-67.2)%)) as well as on a lobar level and correlated with lung function test parameters (PREFUL-QDP vs. FEV 1 , r = -0.75, P < 0.0001). There was a systematic overestimation of PREFUL-QDP compared with PBF-QDP, mainly in the lower lobes, resulting in an overall overestimation for the whole lung with a mean difference of 5% (95% confidence interval [CI]: 3.0%; 7.0%; STD 6.8%). Data Conclusion: PREFUL-MRI is a promising noninvasive, radiation-free tool for quantification of regional perfusion in COPD patients. Level of Evidence: 1 Technical Efficacy: Stage 2

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confidence: 99%

Comparison of quantitative regional perfusion‐weighted phase resolved functional lung (PREFUL) MRI with dynamic gadolinium‐enhanced regional pulmonary perfusion MRI in COPD patients

Kaireit

Voskrebenzev

Gutberlet

et al. 2018

Magnetic Resonance Imaging

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“…However, a major limitation of CT is cumulative ionizing radiation associated with repeated CT exams, which are often needed to monitor the development of lesions in longitudinal studies. On the other hand, although lung MRI has been more challenging compared to other MR exams due to the presence of air, respiratory/cardiac motion, and the short

{normalT}_{2}^{*}

of the lung parenchyma, remarkable technological advances have been achieved during the past years to address these challenges, and multiple studies have demonstrated convincing imaging performance of lung MRI with appropriate scan times . However, one of the main challenges of conventional MRI using Cartesian acquisitions is the sensitivity to motion (ie, heart beating or respiration) and the requirement of breath‐holds in clinical routine.…”

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confidence: 99%

Free‐breathing dynamic contrast‐enhanced MRI for assessment of pulmonary lesions using golden‐angle radial sparse parallel imaging

Chen

Liu

Zhang

et al. 2018

Magnetic Resonance Imaging

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“…When using power injectors this technique is particularly helpful for visualizing perfusion defects when pursuing subtraction images (Fig. 6 d and 7 c) [ 147 , 148 ].…”

Section: Magnetic Resonance Angiographymentioning

confidence: 99%

Acute pulmonary embolism multimodality imaging prior to endovascular therapy

Sin

McLennan

Rengier

et al. 2020

Int J Cardiovasc Imaging

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The manuscript discusses the application of CT pulmonary angiography, ventilation-perfusion scan, and magnetic resonance angiography to detect acute pulmonary embolism and to plan endovascular therapy. CT pulmonary angiography offers high accuracy, speed of acquisition, and widespread availability when applied to acute pulmonary embolism detection. This imaging modality also aids the planning of endovascular therapy by visualizing the number and distribution of emboli, determining ideal intra-procedural catheter position for treatment, and signs of right heart strain. Ventilation-perfusion scan and magnetic resonance angiography with and without contrast enhancement can also aid in the detection and pre-procedural planning of endovascular therapy in patients who are not candidates for CT pulmonary angiography.

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Detection of pulmonary embolism with free-breathing dynamic contrast-enhanced MRI

Abstract: Free-breathing DCE MRI may have potential use for the assessment of PE, and does not require patient cooperation in breath-holding.

Cited by 12 publications

References 29 publications

Comparison of quantitative regional perfusion‐weighted phase resolved functional lung (PREFUL) MRI with dynamic gadolinium‐enhanced regional pulmonary perfusion MRI in COPD patients

Comparison of quantitative regional perfusion‐weighted phase resolved functional lung (PREFUL) MRI with dynamic gadolinium‐enhanced regional pulmonary perfusion MRI in COPD patients

Free‐breathing dynamic contrast‐enhanced MRI for assessment of pulmonary lesions using golden‐angle radial sparse parallel imaging

Acute pulmonary embolism multimodality imaging prior to endovascular therapy

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