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Updated: May 29, 2026
Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
Three-dimensional T2-weighted imaging using the dark blood method for detecting pulmonary embolisms: comparison with
Mitsutomi Ishiyama1, Masaki Matsusako, Katsunori Oikado
1Department of Radiology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan. mitishi@luke.or.jp
Purpose:
The aim of this study was to assess the potential diagnostic value of three-dimensional T2-weighted imaging using the dark blood method for detecting pulmonary embolism (PE).
Materials And Methods:
Ten consecutive patients with already diagnosed acute PE (five men, five women; mean age 58.6 years, range 35-79 years) were prospectively enrolled in this study. All patients underwent lung magnetic resonance imaging (MRI) with a 1.5-T scanner. MRI was performed on the same day as CT angiography (CTA), which was undertaken to monitor treatment. Two radiologists performed a consensus evaluation of MRI followed by CTA on a per-vessel basis: the main pulmonary artery (PA), lobar PA, segmental PA, and subsegmental PA. Each modality was evaluated independently on separate days (at least 8 weeks apart). The accuracy of MRI for detecting PE was determined by comparing it with CTA results, which were used as a reference standard. Cohen's kappa analysis was used for statistical analyses.
Results:
Among the 10 patients, pulmonary emboli were seen in 6 of 20 main arteries, 22 of 60 lobar arteries, 35 of 180 segmental arteries, and 8 of 410 subsegmental arteries on CTA. The sensitivities/specificities of MRI were 100%/100% for the main PA, 90.9%/97.3% for the lobar PA, and 74.2%/97.9% for the segmental PA, respectively. Altogether, 304 (83%) of 410 subsegmental arteries were not visualized on MRI and only 1 of the 8 emboli in the subsegmental branches was depicted. The kappa values for the main, lobar, and segmental arteries were 1.0, 0.89, and 0.77, respectively.
Conclusion:
Three-dimensional T2-weighted imaging using the dark blood method appears to be principally useful for diagnosing main, lobar, and segmental PEs.
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