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Magnetic resonance detection of acute pulmonary emboli in a canine model with pathologic correlation
T V Huynh1, C J Bergin, J Hauschildt
1Department of Radiology, University of California, San Diego 92103-8756, USA.
Rationale And Objectives:
The authors evaluated the accuracy of magnetic resonance (MR) imaging in depicting acute pulmonary emboli at the lobar, segmental, and subsegmental levels.
Methods:
The authors induced 29 autologous emboli in five dogs and confirmed their location with angiography and anatomic dissection. MR images obtained with four sequences were independently evaluated by two radiologists to detect emboli in each vascular segment. Sensitivities, specificities, and accuracies were calculated at segmental and lobar levels.
Results:
The fast short-tau inversion-recovery images provided the greatest conspicuity and highest overall accuracy (reader 1 = 74.3%, reader 2 = 80%). Accuracy of two-dimensional fast multiplanar spoiled gradient-recalled-echo images was limited by spatial resolution (reader 1 = 71.4%, reader 2 = 74.3%). The fast spin-echo T2-weighted and spin-echo T1-weighted sequences were intermediate in their depiction of acute emboli. Similar results were seen at the lobar level.
Conclusion:
MR images depict acute pulmonary embolism at the segmental and lobar levels with reasonable accuracy. Fast short-tau inversion-recovery sequences provided the greatest sensitivity and accuracy.
Insights
Magnetic resonance (MR) imaging shows reasonable accuracy for detecting acute pulmonary embolism. Fast short-tau inversion-recovery sequences offer the highest accuracy for diagnosing these emboli at lobar and segmental levels.
Area of Science:
- Radiology
- Medical Imaging
- Cardiovascular Imaging
Background:
- Pulmonary embolism (PE) is a significant cause of morbidity and mortality.
- Accurate and timely diagnosis of PE is crucial for effective treatment.
- Magnetic resonance (MR) imaging is a non-invasive modality with potential for PE detection.
Purpose of the Study:
- To evaluate the diagnostic accuracy of different MR imaging sequences for acute pulmonary emboli.
- To assess MR imaging performance at lobar, segmental, and subsegmental levels.
Main Methods:
- Autologous emboli were induced in five dogs and confirmed via angiography and dissection.
- Four MR imaging sequences were used to image the emboli.
- Two radiologists independently evaluated MR images for emboli detection at segmental and lobar levels.
- Sensitivity, specificity, and accuracy were calculated for each sequence.
Main Results:
- Fast short-tau inversion-recovery (FSTIR) sequences demonstrated the highest conspicuity and overall accuracy (74.3%-80%).
- Two-dimensional fast multiplanar spoiled gradient-recalled-echo (2D FMSGR) sequences had limited accuracy due to spatial resolution (71.4%-74.3%).
- Fast spin-echo T2-weighted and spin-echo T1-weighted sequences showed intermediate accuracy.
Conclusions:
- MR imaging can depict acute pulmonary embolism with reasonable accuracy at lobar and segmental levels.
- FSTIR sequences are superior for detecting acute pulmonary emboli, offering the greatest sensitivity and accuracy.