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Magnetic Resonance Imaging of Pulmonary Embolism: Diagnostic Accuracy of Unenhanced MR and Influence in Mortality Rates

  • Pulmonary Vascular Disease
  • Published:
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Abstract

Objectives

We evaluated the diagnostic value for pulmonary embolism (PE) of the True fast imaging with steady-state precession (TrueFISP) MRI, a method that allows the visualization of pulmonary vasculature without breath holding or intravenous contrast.

Methods

This is a prospective investigation including 93 patients with suspected PE. All patients underwent TrueFISP MRI after undergoing CT pulmonary angiography (CTPA). Two independent readers evaluated each MR study, and consensus was obtained. CTPA results were analysed by a third independent reviewer and these results served as the reference standard. A fourth radiologist was responsible for evaluating if lesions found on MRI for both analysis were the same and if these were the correspondent lesions on the CTPA. Sensitivity, specificity, predictive values and accuracy were calculated. Evidence for death from PE within the 1-year follow-up was also assessed.

Results

Two patients could not undergo the real-time MRI and were excluded from the study. PE prevalence was 22%. During the 1-year follow-up period, eight patients died, whereas PE was responsible for 12.5% of cases. Between patients who developed PE, only 5% died due to this condition. There were no differences between MR and CT embolism detection in these subjects. MR sequences had a sensitivity of 85%, specificity was 98.6% and accuracy was 95.6%. Agreement between readers was high (κ= 0.87).

Conclusions

Compared with contrast-enhanced CT, unenhanced MR sequences demonstrate good accuracy and no differences in the mortality rates in 1 year were detected.

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Abbreviations

CTPA:

Computed tomography pulmonary angiogram

PE:

Pulmonary embolism

ROC:

Receiver operating characteristic

RT-MRI:

Real-time magnetic resonance imaging

SD:

Standard deviation

SSPE:

Subsegmental pulmonary embolism

TE:

Echo time

TR:

Repetition time

TrueFISP:

True fast imaging with steady-state precession

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Av. Independência, 75, Porto Alegre, 90020-160, Brazil

    Lilian Pasin, Matheus Zanon, Jose Moreira, Ana Luiza Moreira & Bruno Hochhegger

  2. Department of Clinical Medicine, Federal University of Health Sciences of Porto Alegre, R. Sarmento Leite, 245, Porto Alegre, 90050-170, Brazil

    Matheus Zanon & Bruno Hochhegger

  3. Post-Graduation Program in Chest Medicine Sciences, Federal University of Rio Grande do Sul, R. Ramiro Barcelos, 2400, Porto Alegre, 90035-003, Brazil

    Guilherme Watte

  4. Department of Radiology, Faculdade de Medicina da Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho, 373, Rio de Janeiro, 21941-902, Brazil

    Edson Marchiori

  5. R. Luiz Afonso, 307, 407 – Cidade Baixa, Porto Alegre, RS, 90050-310, Brazil

    Matheus Zanon

Authors
  1. Lilian Pasin
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  2. Matheus Zanon
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  3. Jose Moreira
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  4. Ana Luiza Moreira
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  5. Guilherme Watte
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  6. Edson Marchiori
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  7. Bruno Hochhegger
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Corresponding author

Correspondence to Matheus Zanon.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. ISCMPA Committee (Porto Alegre, Brazil).

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Pasin, L., Zanon, M., Moreira, J. et al. Magnetic Resonance Imaging of Pulmonary Embolism: Diagnostic Accuracy of Unenhanced MR and Influence in Mortality Rates. Lung 195, 193–199 (2017). https://doi.org/10.1007/s00408-017-9975-7

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  • DOI: https://doi.org/10.1007/s00408-017-9975-7

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