MR Imaging of Pulmonary Embolism: Diagnostic Accuracy of Contrast-enhanced 3D MR Pulmonary Angiography, Contrast-enhanced Low–Flip Angle 3D GRE, and Nonenhanced Free-Induction FISP Sequences

Kalb, Bobby; Sharma, Puneet; Tigges, Stefan; Ray, Gaye L.; Kitajima, Hiroumi D.; Costello, James; Chen, Zhengjia; Martín, Diego R.

doi:10.1148/radiol.12110224

Cited by 94 publications

(89 citation statements)

References 16 publications

(17 reference statements)

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“…Additionally, there is a growing awareness of potential risks associated with ionizing radiation and increased CT angiography use, especially in young patients (5). Contrast material-enhanced magnetic resonance (MR) angiography is emerging as an attractive nonionizing alternative with which to detect PE (4,(6)(7)(8)(9)(10)(11).…”

Section: Implications For Patient Carementioning

confidence: 99%

See 1 more Smart Citation

Pulmonary Embolism Detection with Three-dimensional Ultrashort Echo Time MR Imaging: Experimental Study in Canines

Bannas¹,

Bell²,

Johnson³

et al. 2016

Radiology

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q RSNA, 2015 Purpose:To demonstrate the feasibility of free-breathing three-dimensional (3D) radial ultrashort echo time (UTE) magnetic resonance (MR) imaging in the simultaneous detection of pulmonary embolism (PE) and high-quality evaluation of lung parenchyma. Materials andMethods:The institutional animal care committee approved this study. A total of 12 beagles underwent MR imaging and computed tomography (CT) before and after induction of PE with autologous clots. Breath-hold 3D MR angiography and freebreathing 3D radial UTE (1.0-mm isotropic spatial resolution; echo time, 0.08 msec) were performed at 3 T. Two blinded radiologists independently marked and graded all PEs on a four-point scale (1 = low confidence, 4 = absolutely certain) on MR angiographic and UTE images. Image quality of pulmonary arteries and lung parenchyma was scored on a four-point-scale (1 = poor, 4 = excellent). Locations and ratings of emboli were compared with reference standard CT images by using an alternative free-response receiver operating characteristic curve (AFROC) method. Areas under the curve and image quality ratings were compared by using the F test and the Wilcoxon signed-rank test. Results:A total of 48 emboli were detected with CT. Both readers showed higher sensitivity for PE detection with UTE (83% and 79%) than with MR angiography (75% and 71%). The AFROC area under the curve was higher for UTE than for MR angiography (0.95 vs 0.89), with a significant difference in area under the curve of 0.06 (95% confidence interval: 0.01, 0.11; P = .018). UTE image quality exceeded that of MR angiography for subsegmental arteries (3.5 6 0.7 vs 2.9 6 0.5, P = .002) and lung parenchyma (3.8 6 0.5 vs 2.2 6 0.2, P , .001). The apparent signal-to-noise ratio in pulmonary arteries and lung parenchyma was significantly higher for UTE than for MR angiography (41.0 6 5.2 vs 24.5 6 6.2 [P , .001] and 10.2 6 1.8 vs 3.5 6 0.8 [P , .001], respectively). The apparent contrast-to-noise ratio between arteries and PEs was higher for UTE than for MR angiography (20.3 6 5.2 vs 15.4 6 6.7, P = .055). Conclusion:In a canine model, free-breathing 3D radial UTE performs better than breath-hold 3D MR angiography in the detection of PE and yields better image quality for visualization of small vessels and lung parenchyma. Free-breathing 3D radial UTE for detection of PE is feasible and warrants evaluation in human subjects.q RSNA, 2015

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Section: Implications For Patient Carementioning

confidence: 99%

“…Previous studies have reported varying diagnostic performance with current MR angiography methods (4,(7)(8)(9)(10)(11). The recent multicenter PIOPED III study showed a sensitivity and specificity for acute PE of only 78% and 99%, respectively (4).…”

Section: Experimental Studies: Pulmonary Embolism Detection Bannas Et Almentioning

confidence: 99%

Pulmonary Embolism Detection with Three-dimensional Ultrashort Echo Time MR Imaging: Experimental Study in Canines

Bannas¹,

Bell²,

Johnson³

et al. 2016

Radiology

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“…In recent studies, balanced SSFP, or called TrueFISP, has been used in cardiovascular imaging. TrueFISP has demonstrated high specificity for evaluation of pulmonary embolism (17). Compared to contrastenhanced MRA, high image quality, high SNR and CNR were found in imaging of different target vessels (18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

Assessment of thoracic vasculature in patients with central bronchogenic carcinoma by unenhanced magnetic resonance angiography: comparison between 2D free-breathing TrueFISP, 2D breath-hold TrueFISP and 3D respiratory-triggered SPACE

Wang¹,

Lv²,

Yang³

et al. 2017

J. Thorac. Dis.

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“…Recentemente, Kalb e cols. 58 avaliaram a detecção de TEP através da angiorressonância magnética pulmonar padrão com injeção de contraste e aquisição de imagens em apneia, através da técnica de recirculação de fase de contraste tridimensional gradiente-echo utilizando baixo flip angle e através da sequência de imagem sem realce true fast com steady-state precession. Eles acharam que as três sequências combinadas aumentaram a sensibilidade para 84%.…”

Section: Angiorressonância Magnética E Tepunclassified

“…Eles acharam que as três sequências combinadas aumentaram a sensibilidade para 84%. A especificidade foi de 100% para todos os métodos, exceto para a angiorressonância magnética pulmonar (1 falso-positivo) 58 .…”

Section: Angiorressonância Magnética E Tepunclassified

Value of Cardiac Magnetic Resonance Image in the Approach of the Patient with Suspect Acute Coronary Syndrome and Normal Angiography

Santana¹

2014

Arquivos Brasileiros De Cardiologia - Imagem Cardiovascular

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Resumo E s t i m a -s e q u e p a c i e n t e s a d m i t i d o s c o m d o rtorácica, níveis elevados de troponina e alterações eletrocardiográficas com coronariografia normal ou discretamente alterada representem 2,6% a 19% dos casos inicialmente diagnosticados como infarto agudo do miocárdio. Nessa situação, o diagnóstico adequado é um desafio para o cardiologista. A ressonância magnética cardiovascular tem sido usada como um importante instrumento para definição entre infarto agudo do miocárdio real e uma doença que simule esse diagnóstico, conduzindo ao tratamento adequado e melhora no prognóstico. Resumo E s t i m a -s e q u e p a c i e n t e s a d m i t i d o s c o m d o rtorácica, níveis elevados de troponina e alterações eletrocardiográficas com coronariografia normal ou discretamente alterada representem 2,6% a 19% dos casos inicialmente diagnosticados como infarto agudo do miocárdio. Nessa situação, o diagnóstico adequado é um desafio para o cardiologista. A ressonância magnética cardiovascular tem sido usada como um importante instrumento para definição entre infarto agudo do miocárdio real e uma doença que simule esse diagnóstico, conduzindo ao tratamento adequado e melhora no prognóstico.

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MR Imaging of Pulmonary Embolism: Diagnostic Accuracy of Contrast-enhanced 3D MR Pulmonary Angiography, Contrast-enhanced Low–Flip Angle 3D GRE, and Nonenhanced Free-Induction FISP Sequences

Abstract: There are complementary benefits to combining standard MR pulmonary angiography, 3D GRE, and triggered true FISP MR examinations for evaluation of PE.

Cited by 94 publications

References 16 publications

Pulmonary Embolism Detection with Three-dimensional Ultrashort Echo Time MR Imaging: Experimental Study in Canines

Pulmonary Embolism Detection with Three-dimensional Ultrashort Echo Time MR Imaging: Experimental Study in Canines

Assessment of thoracic vasculature in patients with central bronchogenic carcinoma by unenhanced magnetic resonance angiography: comparison between 2D free-breathing TrueFISP, 2D breath-hold TrueFISP and 3D respiratory-triggered SPACE

Value of Cardiac Magnetic Resonance Image in the Approach of the Patient with Suspect Acute Coronary Syndrome and Normal Angiography

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