Authors: Alexander Kluge Clemens Müller Jochen Hansel Tibo Gerriets Georg Bachmann
Publish Date: 2003/12/05
Volume: 14, Issue: 4, Pages: 709-718
Abstract
The feasibility and diagnostic value of realtime magnetic resonance imaging RTMRI for the diagnosis of acute pulmonary embolism PE was evaluated by comparing RTMRI and magnetic resonance angiography MRA In 39 consecutive patients with suspected PE realtime true fast imaging with steadystate precession TrueFisp was prospectively compared with contrastenhanced MRA on a 15T MR scanner The TrueFisp sequence used allowed acquisition of T2weighted images at 04 s per image so that the pulmonary vasculature could be visualized in three orientations in 3 min without the need for breath holding or contrast media application Results of additional scintigraphic pulmonary perfusion examinations were available from 17 patients All 39 primary RT examinations 100 and 30 of 39 MRA examinations 77 were of diagnostic quality The reasons underlying failure to achieve diagnostic quality for MRA were breathing artifacts among dyspneic patients in all 9 cases Compared with MRA the sensitivities and specificities of RT sequences for PE were 93 and 100 per examination 96 and 100 lobar artery PE and 97 and 100 segmental artery PE respectively Compared with scintigraphy the sensitivity and specificity of RTMRI were 83 and 100 respectively The MRA reached 100 sensitivity and specificity in this subgroup The RTMRI proved to be very robust and undisturbed by respiratory movements and patient cooperation Its image quality assured fast diagnostic examinations and its sensitivity and specificity compared with MRA and scintigraphy were sufficient to allow the diagnosis of acute central lobar and segmental PE therefore the emergency diagnosis of PE using RTMRI is feasible and reliable
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