Role of MRI in diagnosis of pulmonary embolism

Abstract

Abstract Background Pulmonary embolism (PE) is considered a serious condition and has clinical challenges in diagnosis. Computed tomography pulmonary angiography (CTPA) is considered the gold standard in PE diagnosis. Contrast-enhanced MRA also has a strong useful role in the diagnosis. Our study aims to assess the role of non-contrast MRA in diagnosis of acute pulmonary embolism compared to either CT pulmonary angiography or contrast enhanced MRA. Results In total, 50 patients with PE confirmed by either CTPA or CE-MRA were included in this study. All patients underwent non-contrast MRPA during the three consecutive days after CTPA or at the same examination setting in CE-MRA. The results were compared and statistically analyzed. The mean age of our study group was 47.80 ± 14.01 years. Males represented 56% (28/50) and females 44% (22/50). The per-vessel sensitivity, specificity and accuracy of non-contrast MRPA reached about 100% for each parameter at the level of the pulmonary trunk, main pulmonary and lobar arteries. At the segmental level, sensitivity, specificity, and accuracy reached about 88%, 100%, and 94%, while at the subsegmental level, about 35%, 100%, and 66% respectively. The overall sensitivity, specificity, and accuracy of non-contrast MRPA regardless of the site were 84%, 100%, and 90% respectively. Conclusions Non-contrast pulmonary MRA has a high sensitivity and specificity in the diagnosis of PE, especially in proximal pulmonary arteries. So, it can be used as an alternative to the CTA and CE-MRA, especially when the CTA and the use of gadolinium are contraindicated.

Keywords

• MRI
• Diagnosis
• Pulmonary embolism
• Multi-slice CT
• CT pulmonary angiography