Role of MRI in diagnosis of pulmonary embolism

Abstract

BackgroundPulmonary 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.ResultsIn 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.ConclusionsNon-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.