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MRI for short-term follow-up of acute pulmonary embolism. Assessment of thrombus appearance and pulmonary perfusion: a feasibility study

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Abstract

Tha aim of this study was to demonstrate the feasibility of MRI for short-term follow-up examinations in patients with acute pulmonary embolism (PE), and to assess temporal changes of pulmonary perfusion and thrombus characteristics that may be helpful in determining thrombus age. Thirty-three patients (15 female, 18 male, mean age 59.4 years) with acute PE were examined initially and 1 week later using both 16-row computed tomography (CT) and MRI with magnetic resonance angiography (MRA), real-time MRI and magnetic resonance (MR) pulmonary perfusion imaging. MRA and MR pulmonary perfusion used contrast-enhanced 3D flash sequences, and real-time MRI used true fast imaging with steady-state precession sequences (repetition time/echo time 3.1/1.5, bandwidth 975 Hz, 256 matrix size, acquisition time 0.4 s per image) in three orthogonal planes. Follow-up examinations were feasible for all patients. Diagnosis of PE was concordant between MRI and CT in all patients. The signal intensity of embolic material increased after 1 week for real-time MRI [132±5 vs. 232±22 (standard error of the mean), p<0.001], but not significantly for MRA. MR pulmonary perfusion of areas affected by PE increased (area under the curve initially 9.6±7.4, at follow-up 40.7±7.6, p<0.001). A decreasing time-to-peak in normal lung areas (15.7±0.96 and 13.2±0.55, respectively, p<0.05) indicated systemic circulatory effects of PE, and subsiding pulmonary artery obstruction improved arterial inflow for the entire lung. Follow-up examinations of patients with acute PE are feasible with MRI, and a relation between thrombus appearance and thrombus age can be implied.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Kerckhoff Heart Center, Benekestrasse 2–8, 61231, Bad Nauheim, Germany

    Alexander Kluge, Tibo Gerriets, Uwe Lange & George Bachman

  2. Department of Rheumatology, Kerckhoff Heart Center, Benekestrasse 2–8, 61231, Bad Nauheim, Germany

    Uwe Lange

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  1. Alexander Kluge
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  2. Tibo Gerriets
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  3. Uwe Lange
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  4. George Bachman
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Correspondence to Alexander Kluge.

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Kluge, A., Gerriets, T., Lange, U. et al. MRI for short-term follow-up of acute pulmonary embolism. Assessment of thrombus appearance and pulmonary perfusion: a feasibility study. Eur Radiol 15, 1969–1977 (2005). https://doi.org/10.1007/s00330-005-2760-7

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  • DOI: https://doi.org/10.1007/s00330-005-2760-7

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