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2018 ; 10
(6
): 52-64
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Magnetic resonance angiography for the primary diagnosis of pulmonary embolism: A
review from the international workshop for pulmonary functional imaging
#MMPMID29988845
Tsuchiya N
; van Beek EJ
; Ohno Y
; Hatabu H
; Kauczor HU
; Swift A
; Vogel-Claussen J
; Biederer J
; Wild J
; Wielpütz MO
; Schiebler ML
World J Radiol
2018[Jun]; 10
(6
): 52-64
PMID29988845
show ga
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.