Published ahead of print on November 21, 2002, doi:10.1164/rccm.200208-899OC Am. J. Respir. Crit. Care Med., Volume 167, Number 5, March 2003, 729-734 A more recent version of this article appeared on March 1, 2003
Submitted on August 20, 2002 Pulmonary Embolism: Comparison of Angiography with Spiral CT, MRA and Real-Time MR imagingPatrick Haage1*,1 Department of Diagnostic Radiology, University of Technology Aachen, Aachen, Germany, 2 Philips Research Laboratories, Hamburg, Germany * To whom correspondence should be addressed. E-mail: haage{at}rad.rwth-aachen.de.
In the last decade, Spiral Computed Tomography (CT) and Magnetic Resonance Angiography (MRA) have become a viable alternative to conventional angiography in the diagnosis of acute pulmonary embolism. However, dyspneic patients are often unable to hold their breath for a longer time and thus image degradation is frequently observed. Consequently, a imaging sequence that allows free breathing is desirable. The aim of this animal study was to compare contrast-enhanced Spiral CT, MRA and a real-time MR sequence, the latter without breath-hold, to pulmonary angiography as reference gold standard. Nine pigs with artificially induced pulmonary embolism underwent this multi-modality comparison. All images were independently evaluated for the presence of pulmonary emboli by two reviewers. Forty-three filling defects were detected by conventional angiography on lobar and segmental level. Sensitivity of CT images was 72.1% and 69.8% for reader 1 and 2, respectively, sensitivity of MRA images was 79.1% and 81.4%. With real-time MR imaging, however, the detection rate was 97.7% for both readers. We conclude, that under experimental conditions, real-time MR imaging without the use of radiation or iodinated contrast material is comparable to angiography in the detection of pulmonary emboli. Key words: Pulmonary Embolism, diagnosis; Spiral Computed Tomography; Magnetic Resonance Angiography; Real-time Magnetic Resonance Imaging
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