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Cine-gradient-refocused MR imaging of central pulmonary emboli
R H Posteraro1, H D Sostman, C E Spritzer
1Department of Radiology, Duke University Medical Center, Durham, NC 27710.
AJR. American Journal of Roentgenology
|March 1, 1989
Summary
This study demonstrates that cine-MR imaging effectively detects central pulmonary emboli and differentiates acute from chronic cases. The limited-flip-angle sequence proved accurate in identifying pulmonary embolism in patients.
Area of Science:
- Radiology
- Cardiovascular Imaging
- Pulmonary Medicine
Background:
- Central pulmonary embolism is a critical condition requiring accurate diagnosis.
- Distinguishing between acute and chronic pulmonary emboli is essential for appropriate patient management.
- Magnetic Resonance (MR) imaging offers potential for non-invasive visualization of pulmonary vasculature.
Purpose of the Study:
- To evaluate the efficacy of a limited-flip-angle, gradient-refocused MR pulse sequence (cine-MR) in detecting central pulmonary emboli.
- To assess the capability of cine-MR imaging to differentiate between acute and chronic pulmonary emboli.
- To correlate cine-MR findings with conventional diagnostic methods such as angiography and scintigraphy.
Main Methods:
- Eleven patients with suspected central pulmonary embolism underwent cine-MR imaging using a limited-flip-angle (30 degrees) gradient-refocused pulse sequence (63/13 TR/TE).
- Standard spin-echo MR sequences were also utilized for comparison.
- Findings were correlated with results from angiography, perfusion scintigraphy, and pathological examination where available, based on original reports and blinded expert review.
Main Results:
- Cine-MR imaging successfully visualized central pulmonary emboli in all 11 patients, with findings consistent with locations of abnormalities seen on angiography and perfusion defects on scintigraphy.
- The technique showed good agreement with conventional methods in differentiating acute from chronic emboli, although discrepancies were noted in a few cases, sometimes clarified by pathological findings.
- In cases where angiography suggested mixed acute and chronic emboli, cine-MR accurately identified acute embolism.
Conclusions:
- Cine-MR imaging, utilizing a limited-flip-angle, gradient-refocused pulse sequence, is an accurate method for demonstrating central pulmonary emboli.
- This MR technique shows promise in distinguishing acute from chronic pulmonary emboli, aiding in the diagnosis of pulmonary embolism.
- The study suggests cine-MR is a valuable tool in the assessment of central pulmonary vascular disease.