Magnetic resonance angiography for the primary diagnosis of pulmonary embolism: A review from the international workshop for pulmonary functional imaging

Tsuchiya, Nanae; Ej, van Beek; Ohno, Yoshiharu; Hatabu, Hiroto; Kauczor, HU; Swift, Andy; Vogel‐Claussen, Jens; Biederer, Jürgen; Wild, Jim M.; Wielpütz, MO; Schiebler, Mark L.

doi:10.4329/wjr.v10.i6.52

Cited by 26 publications

(20 citation statements)

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“…MRI can also provide an evaluation of the pulmonary vasculature and is increasingly being used in select centers for the evaluation of known or suspected CTEPH. 4D DCE lung perfusion MRI techniques 201 are widely available on current MRI systems and have shown excellent test performance in diagnosing CTEPH in a single center registry setting. 39 In addition, a non-contrast, free-breathing ventilation perfusion MRI technique, known as the Fourier Decomposition (FD)-MRI method 202,203 has recently shown initial encouraging results in diagnosing chronic pulmonary embolism; 204 however, this technique needs to be confirmed in larger multicenter studies.…”

Section: Section 2: Imaging Adults With Pulmonary Hypertensionmentioning

confidence: 99%

Statement on imaging and pulmonary hypertension from the Pulmonary Vascular Research Institute (PVRI)

Kiely¹,

Levin²,

et al. 2019

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Pulmonary hypertension (PH) is highly heterogeneous and despite treatment advances it remains a life-shortening condition. There have been significant advances in imaging technologies, but despite evidence of their potential clinical utility, practice remains variable, dependent in part on imaging availability and expertise. This statement summarizes current and emerging imaging modalities and their potential role in the diagnosis and assessment of suspected PH. It also includes a review of commonly encountered clinical and radiological scenarios, and imaging and modeling-based biomarkers. An expert panel was formed including clinicians, radiologists, imaging scientists, and computational modelers. Section editors generated a series of summary statements based on a review of the literature and professional experience and, following consensus review, a diagnostic algorithm and 55 statements were agreed. The diagnostic algorithm and summary statements emphasize the key role and added value of imaging in the diagnosis and assessment of PH and highlight areas requiring further research.

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Section: Section 2: Imaging Adults With Pulmonary Hypertensionmentioning

confidence: 99%

Statement on imaging and pulmonary hypertension from the Pulmonary Vascular Research Institute (PVRI)

Kiely¹,

Levin²,

et al. 2019

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“…Perfusion defects may also be evident at contrast-enhanced MR angiography when used for suspected acute pulmonary embolism (in selected patients with low to intermediate pretest probability, iodinated contrast allergy, and female patients aged .35 years) (Fig 7) (81).…”

Section: Pulmonary Vascular Diseasementioning

confidence: 99%

Pulmonary Functional Imaging: Part 2—State-of-the-Art Clinical Applications and Opportunities for Improved Patient Care

et al. 2021

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P ulmonary functional imaging may be defined as the regional quantification of lung function by using primarily CT, MRI, and nuclear medicine techniques. The distribution of pulmonary physiologic parameters including ventilation, perfusion, gas exchange, and biomechanics can be mapped and measured noninvasively throughout the entire lungs. This regional and localized information is inaccessible by using conventional pulmonary function tests. Moreover, techniques such as hyperpolarized (HP) helium 3 ( 3 He) and xenon 129 ( 129 Xe) gas MRI are able to probe lung physiologic structure and microstructure down to the level of the alveolar-capillary units (1-3). This is beyond the spatial resolution of modern clinical CT scanners.Our review aims to provide an overview of the current status of pulmonary functional imaging. The technical and physiologic underpinnings of these pulmonary functional imaging methods were discussed in part 1 of this review (4). Here in part 2, we focus on current and emerging clinical applications. Both the multiple opportunities and the challenges in the clinical translation and deployment of pulmonary functional imaging in routine clinical practice are presented. Several approaches to facilitating clinical adoption are suggested. With continued progress in this active field, pulmonary functional imaging is anticipated to have an increasing role in our understanding of pulmonary disease and in the imaging evaluation of patients with lung disorders as illustrated in the clinical disorders discussed. OpportunitiesBecause virtually all lung disorders are heterogeneously distributed in the lungs, the regional and spatially localized information provided by using pulmonary functional imaging provides clinically relevant information beyond that of conventional pulmonary function tests. The latter, including spirometry, diffusing capacity for carbon monoxide, and body plethysmography, measure total lung function without spatial localization. Furthermore, pulmonary functional imaging methods such as HP gas MRI with 3 He and 129 Xe can probe function and microstructure at the level of the alveolar-capillary interface (1-3,5-7), as discussed in part 1 (4). This is the site of gas exchange, the fundamental and vital function of the lungs. The alveolar-capillary units are beyond the anatomic resolution of current clinical scanners such as high-spatial-resolution CT. The functional and microstructural abnormalities depicted at pulmonary functional imaging may occur early in the evolution of lung Pulmonary functional imaging may be defined as the regional quantification of lung function by using primarily CT, MRI, and nuclear medicine techniques. The distribution of pulmonary physiologic parameters, including ventilation, perfusion, gas exchange, and biomechanics, can be noninvasively mapped and measured throughout the lungs. This information is not accessible by using conventional pulmonary function tests, which measure total lung function without viewing the regional distribution. The latter is importan...

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“…Größere Erfahrungen mit diesem Hybridansatz in klinischen Studien stehen aus. Eine Alternative, die vor allem bei schwangeren Patientinnen, Frauen unter 35 Jahren, bei Iodallergie oder schwerer Niereninsuffizienz in Betracht gezogen werden kann, ist die weniger verbreitete pulmonale kontrastverstärkte Magnetresonanzangiografie (CE-MRA) [7]. Andere Modalitäten der Bildgebung, wie die Ventilations-/Perfusions-PET/CT (V/Q PET/CT), befinden sich derzeit noch im experimentellen Stadium [8].…”

Section: Diagnostik Der Lungenarterienembolieunclassified

Update Lungenarterienembolie

Stimpfle

Geisler

2019

Klinikarzt

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ZUSAMMENFASSUNGDie korrekte Behandlung der Lungenarterienembolie beginnt mit einer frühzeitigen multimodalen Einschätzung des Risikos unter Berücksichtigung der klinischen Vorhersagekraft, Laborparametern und bildmorphologischen Risikomerkmalen. Während die Lysetherapie hauptsächlich Patienten mit Schocksituation vorbehalten ist, kann sie bei ausgewählten stabilen Patienten mit intermediär hohem Risiko und vertretbarem Blutungsrisiko ebenfalls in Betracht gezogen werden. Im Niedrigrisikobereich ist eine ambulante Behandlung vertretbar. Neue Aspekte umfassen auch den Einsatz von kathetergestützen Reperfusionsmaßnahmen, sowie Algorithmen, um das Langzeitrezidivrisiko als auch die Entwicklung einer chronisch thrombembolischen pulmonalen Hypertonie frühzeitig zu erkennen. Der Vorteil der verlängerten Sekundärprophylaxe nach Lungenarterienembolie ist bei bestimmten Patienten durch Anwendung von klinischen Vorhersagemodellen und auch im Bereich der Tumorerkrankungen durch aktuelle Studiendaten belegt worden. Dieser Übersichtsartikel dient als Update unter Berücksichtigung der aktuellen Entwicklung und liefert Perspektiven über derzeit laufende Studien zur Klärung von offenen Fragen in der Behandlung der Lungenarterienembolie.

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Magnetic resonance angiography for the primary diagnosis of pulmonary embolism: A review from the international workshop for pulmonary functional imaging

Cited by 26 publications

References 101 publications

Statement on imaging and pulmonary hypertension from the Pulmonary Vascular Research Institute (PVRI)

Statement on imaging and pulmonary hypertension from the Pulmonary Vascular Research Institute (PVRI)

Pulmonary Functional Imaging: Part 2—State-of-the-Art Clinical Applications and Opportunities for Improved Patient Care

Update Lungenarterienembolie

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