Magnetic resonance angiography for the primary diagnosis of pulmonary embolism: A review from the international workshop for pulmonary functional imaging

Pulmonary contrast enhanced magnetic resonance angiography (CE-MRA) is useful for the primary diagnosis of pulmonary embolism (PE). Many sites have chosen not to use CE-MRA as a first line of diagnostic tool for PE because of the speed and higher efficacy of computerized tomographic angiography (CTA...

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Published inWorld journal of radiology Vol. 10; no. 6; pp. 52 - 64
Main Authors Tsuchiya, Nanae, Beek, Edwin JR van, Ohno, Yoshiharu, Hatabu, Hiroto, Kauczor, Hans-Ulrich, Swift, Andrew, Vogel-Claussen, Jens, Biederer, Jürgen, Wild, James, Wielpütz, Mark O, Schiebler, Mark L
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Inc 28.06.2018
Subjects
Review
Pulmonary embolism
Radiation induced
Artifacts
Hypersensitivity
Lung
Magnetic resonance angiography
Computerized tomography angiography
Female
Neoplasms
Outcome assessment (health care)
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ISSN1949-8470
1949-8470
DOI10.4329/wjr.v10.i6.52

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Summary:Pulmonary contrast enhanced magnetic resonance angiography (CE-MRA) is useful for the primary diagnosis of pulmonary embolism (PE). Many sites have chosen not to use CE-MRA as a first line of diagnostic tool for PE because of the speed and higher efficacy of computerized tomographic angiography (CTA). In this review, we discuss the strengths and weaknesses of CE-MRA and the appropriate imaging scenarios for the primary diagnosis of PE derived from our unique multi-institutional experience in this area. The optimal patient for this test has a low to intermediate suspicion for PE based on clinical decision rules. Patients in extremis are not candidates for this test. Younger women (< 35 years of age) and patients with iodinated contrast allergies are best served by using this modality We discuss the history of the use of this test, recent technical innovations, artifacts, direct and indirect findings for PE, ancillary findings, and the effectiveness (patient outcomes) of CE-MRA for the exclusion of PE. Current outcomes data shows that CE-MRA and NM V/Q scans are effective alternative tests to CTA for the primary diagnosis of PE.
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Author contributions: Tsuchiya N contributed to design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version; van Beek EJR, Hatabu H and Kauczor HU contributed to conception and design of the study, drafting and critical revision and editing, and final approval of the final version; Ohno Y, Vogel-Claussen J, Wild J and Schiebler ML contributed to conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version; Swift A and Wielpütz MO contributed to literature review and analysis, drafting and critical revision and editing, and final approval of the final version; Biederer J contributed to conception of study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Correspondence to: Mark L Schiebler, MD, Professor, Department of Radiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792, United States. mschiebler@uwhealth.org
ISSN:1949-8470
1949-8470
DOI:10.4329/wjr.v10.i6.52