Radiology, Vol 189, 125-131, Copyright © 1993 by Radiological Society of North America

ARTICLES

Suspected pulmonary embolism: prospective evaluation with pulmonary MR angiography

ML Schiebler, GA Holland, H Hatabu, J Listerud, T Foo, H Palevsky, H Edmunds and WB Gefter
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia.

PURPOSE: To prospectively evaluate three magnetic resonance (MR) imaging techniques for detection of pulmonary embolism. MATERIALS AND METHODS: Eighteen patients in whom the presence of acute or chronic pulmonary emboli was suspected underwent examination with the following pulse sequences: cardiac-gated spin echo, cine spatial modulation of magnetization, and two-dimensional time-of-flight pulmonary breath-hold (PBH) MR angiography. Three radiologists independently and blindly reviewed each case and graded a total of 518 arterial segments for each pulse sequence with a continuous scale of 0%-100% for likelihood of pulmonary embolism. RESULTS: The overall sensitivity of PBH MR angiography for detection of acute pulmonary emboli was 0.85; for chronic emboli, which were smaller in anteroposterior (AP) diameter, the overall sensitivity was 0.42. Emboli larger than 1 cm in AP diameter were typically identified with > 75% confidence with all pulse sequences. CONCLUSION: Acute pulmonary emboli greater than 1 cm in AP diameter were as accurately identified on PBH MR angiograms obtained in 15 seconds as they were on MR images obtained with longer pulse sequences not dependent on breath holding.

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