Pulmonary embolism: comparison of MR images with radionuclide and angiographic studies.

Erdman, William A.; Peshock, Ronald M; Redman, Helen C.; Bonte, Frederick J.; Meyerson, M B; Jayson, Hal T.; Miller, George; Clarke, Geoffrey D.; Parkey, Robert W.

doi:10.1148/radiology.190.2.8284406

Cited by 64 publications

(19 citation statements)

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“…MR angiography is as accurate as CT angiography in demonstrating lobar and segmental emboli (28,29). In a study with angiographic correlation by Erdman et al (30), MR imaging had a sensitivity of 90% and a specificity of 77%, whereas in a study by Gupta et al (29), it had a sensitivity of 85% and a specificity of 96%. Recent MR imaging studies by Hatabu et al (31,32) showed that this modality demonstrates perfusion (31) and ventilation (32) of the lung parenchyma.…”

Section: Acute Pulmonary Embolismmentioning

confidence: 96%

Thrombotic and Nonthrombotic Pulmonary Arterial Embolism: Spectrum of Imaging Findings

Han

Lee

Franquet³

et al. 2003

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Along with clinical examination and laboratory tests, imaging plays a key role in the diagnosis of pulmonary embolism. Multi-detector row helical computed tomography (CT) is particularly helpful in the diagnosis of acute pulmonary thromboembolism (PTE) owing to its capacity to directly show emboli as intravascular filling defects. Although parenchymal abnormalities at CT are nonspecific for acute PTE, they may contribute to a correct diagnosis of chronic PTE, the characteristic helical CT features of which are similar to its angiographic features and include webs or bands, intimal irregularities, abrupt narrowing or complete obstruction of the pulmonary arteries, and "pouching defect." Nonthrombotic pulmonary embolism is an uncommon condition but is sometimes associated with specific imaging findings, including discrete nodules with cavitation (septic embolism), widespread homogeneous and heterogeneous areas of increased opacity or attenuation that typically appear 12-24 hours after trauma (fat embolism), and fine miliary nodules that subsequently coalesce into large areas of increased opacity or attenuation (talcosis). Knowledge of appropriate imaging methods and familiarity with the specific imaging features of pulmonary embolism should facilitate prompt, effective diagnosis.

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Section: Acute Pulmonary Embolismmentioning

confidence: 96%

Thrombotic and Nonthrombotic Pulmonary Arterial Embolism: Spectrum of Imaging Findings

Han

Lee

Franquet³

et al. 2003

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203

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“…We excluded 4065 studies after title and abstract screening. Of the 49 retrieved studies, we identified 19 that met all the inclusion criteria [14,17,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41]: 16 on a patient basis and nine on a vessel basis ( Figure S1). Two of these articles [27,28] shared the same patient population, but evaluated the diagnostic performance of a combined MRI approach and separate MRI sequences (on a patient-based level), respectively.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic performance of magnetic resonance imaging for acute pulmonary embolism: a systematic review and meta‐analysis

Zhou

Liu

et al. 2015

Journal of Thrombosis and Haemostasis

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Diagnostic performance of magnetic resonance imaging for acute pulmonary embolism: a systematic review and meta-analysis. J Thromb Haemost 2015; 13: 1623-34. Summary. Background: With ongoing technical developments , magnetic resonance imaging (MRI) has notably evolved for the assessment of the pulmonary vasculature. However, uncertainty persists about the performance of MRI for the diagnosis of acute pulmonary embolism (APE). Objectives: To clarify the comprehensive role of MRI in diagnosing APE. Methods: Studies were identified through a search of Pubmed and Ovid databases, and the QUADAS-2 tool was applied for quality assessment of the included studies. Results: Fifteen studies based on patients and nine based on vessels were retrieved. The patient-based analysis yielded an overall sensitivity of 0.75 (95% confidence interval, 0.70-0.79) and 0.84 (0.80-0.87) for all patients and patients with technically adequate images, respectively, with an overall specificity of 0.80 (0.77-0.83) and 0.97 (0.96-0.98) and a pooled diagnostic odds ratio (DOR) of 51.07 (18.36-142.05) and 155.22 (86.83-277.47). On average, MRI was technically inadequate in 18.89% of patients (range, 2.10%-27.70%). A direct comparison of different MRI modalities showed that the combined MRI test had the highest pooled DOR and the lowest proportion of inconclusive images. Of note, heterogeneity and moderate quality were observed. On a vessel basis, the MRI had high sensitivity and speci-ficity in larger-order vessels, but a significantly lower sensitivity of 0.55 (0.50-0.60) for subsegmental APE. Conclusions: On a patient-based level, MRI yields high diagnostic accuracy for the detection of APE, especially in technically adequate images, and the inconclusive MRI examinations mainly result from motion artifact and poor arterial opacification. The combined MRI test appears to be a more promising diagnostic tool with greater power of discrimination than single techniques. From a vessel-based perspective, MRI exhibits a high diagnostic capability with proximal arteries, but lacks sensitivity for peripheral embolism.

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“…Magnetic resonance imaging (MRI) is also being utilized to evaluate clinically suspected PE (124,125,183,(203)(204)(205)(206). In a comparison of noncontrast-enhanced MRI with spiral CT, the average sensitivity of CT for five observers was 75%; for MRI it was 46%.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

The Diagnostic Approach to Acute Venous Thromboembolism

Vf¹,

Carroll²,

Bl³

et al. 1999

Am J Respir Crit Care Med

289

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Pulmonary embolism: comparison of MR images with radionuclide and angiographic studies.

Abstract: MR imaging reliably depicts large and medium-size pulmonary emboli, regardless of infiltrates or effusion; hence, it may clarify findings on V-P scans that show intermediate probability of pulmonary embolism or are at variance with the clinical impression.

Cited by 64 publications

References 0 publications

Thrombotic and Nonthrombotic Pulmonary Arterial Embolism: Spectrum of Imaging Findings

Thrombotic and Nonthrombotic Pulmonary Arterial Embolism: Spectrum of Imaging Findings

Diagnostic performance of magnetic resonance imaging for acute pulmonary embolism: a systematic review and meta‐analysis

The Diagnostic Approach to Acute Venous Thromboembolism

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