Free-breathing Arterial Spin Labeling MRI for the Detection of                     Pulmonary Embolism

Othman, Ahmed E.; Zhang, Cecilia; Komma, Yasmin; Munz, Max; Kolb, Manuel; Rath, Dominik; Gückel, Brigitte; Pohmann, R; Nikolaou, Konstantin; Schwartz, Martin; Küstner, Thomas; Martirosian, Petros; Seith, Ferdinand

doi:10.1148/radiol.221998

Cited by 5 publications

(2 citation statements)

References 20 publications

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“…Gadolinium may only be used as a contrast agent in a pregnant woman if it significantly improves diagnostic performance and is expected to improve fetal or maternal outcomes. Breastfeeding should not be interrupted after gadolinium administration [73].…”

Section: Diagnostic Value Of Magnetic Resonance Imagingmentioning

confidence: 99%

Pulmonary Embolism in Pregnancy: A Review for Clinical Practitioners

Makowska,

Treumann,

Venturini

et al. 2024

JCM

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Diagnostic and therapeutic decision-making in pregnancy with suspected pulmonary embolism (PE) is challenging. European and other international professional societies have proposed various recommendations that are ambiguous, probably due to the unavailability of randomized controlled trials. In the following sections, we discuss the supporting diagnostic steps and treatments. We suggest a standardized diagnostic work-up in pregnant patients presenting with symptoms of PE to make evidence-based diagnostic and therapeutic decisions. We strongly recommend that clinical decisions on treatment in pregnant patients with intermediate- or high-risk pulmonary embolism should include a multidisciplinary team approach involving emergency physicians, pulmonologists, angiologist, cardiologists, thoracic and/or cardiovascular surgeons, radiologists, and obstetricians to choose a tailored management option including an interventional treatment. It is important to be aware of the differences among guidelines and to assess each case individually, considering the specific views of the different specialties. This review summarizes key concepts of the diagnostics and acute management of pregnant women with suspected PE that are supportive for the clinician on duty.

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Section: Diagnostic Value Of Magnetic Resonance Imagingmentioning

confidence: 99%

Pulmonary Embolism in Pregnancy: A Review for Clinical Practitioners

Makowska,

Treumann,

Venturini

et al. 2024

JCM

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“…5). 95 One problem independent of the labeling method is that the perfusion that is of clinical interest is blood flowing into local capillaries contributing to gas exchange, not the blood in conduit vessels merely leading to and from these capillaries. Accordingly, it is desirable to discern between these fractions.…”

Section: Techniques Based On Extrinsically Inducedmentioning

confidence: 99%

Magnetic Resonance Imaging of Lung Perfusion

Triphan

Bauman

Konietzke

et al. 2023

Magnetic Resonance Imaging

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“Lung perfusion” in the context of imaging conventionally refers to the delivery of blood to the pulmonary capillary bed through the pulmonary arteries originating from the right ventricle required for oxygenation. The most important physiological mechanism in the context of imaging is the so‐called hypoxic pulmonary vasoconstriction (HPV, also known as “Euler‐Liljestrand‐Reflex”), which couples lung perfusion to lung ventilation. In obstructive airway diseases such as asthma, chronic‐obstructive pulmonary disease (COPD), cystic fibrosis (CF), and asthma, HPV downregulates pulmonary perfusion in order to redistribute blood flow to functional lung areas in order to conserve optimal oxygenation. Imaging of lung perfusion can be seen as a reflection of lung ventilation in obstructive airway diseases. Other conditions that primarily affect lung perfusion are pulmonary vascular diseases, pulmonary hypertension, or (chronic) pulmonary embolism, which also lead to inhomogeneity in pulmonary capillary blood distribution. Several magnetic resonance imaging (MRI) techniques either dependent on exogenous contrast materials, exploiting periodical lung signal variations with cardiac action, or relying on intrinsic lung voxel attributes have been demonstrated to visualize lung perfusion. Additional post‐processing may add temporal information and provide quantitative information related to blood flow. The most widely used and robust technique, dynamic‐contrast enhanced MRI, is available in clinical routine assessment of COPD, CF, and pulmonary vascular disease. Non‐contrast techniques are important research tools currently requiring clinical validation and cross‐correlation in the absence of a viable standard of reference. First data on many of these techniques in the context of observational studies assessing therapy effects have just become available.Level of Evidence5Technical EfficacyStage 5

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