New research shows that the addition of two magnetic resonance imaging (MRI) sequences to a typical MR angiography technique considerably improves detection of pulmonary embolism, a potentially life-threatening situation traditionally recognized by means of computed tomography (CT).
Outcomes of the research are published on-line within the journal Radiology.
Pulmonary embolism happens when a blood clot--normally from the leg--travels to the lung and blocks the pulmonary artery or one among its most important branches. CT angiography is the gold standard for diagnosis, but it exposes patients to ionizing radiation and iodinated distinction agent, which carries a danger of allergic reactions and kidney injury in some patients."MRI is creating a lot sooner than CT," mentioned Diego R. Martin, M.D., Ph.D., head of the Division of Radiology on the University of Arizona School of Medication in Tucson. "The images we're getting are already significantly higher than they have been a yr ago. There is no doubt that sooner or later we will be able to offer a non-radiation-based mostly various to CT for the analysis of pulmonary embolism."MRI has been used for pulmonary embolism detection in pregnant girls and sufferers whose kidneys may be harmed by CT angiography distinction agents. Nonetheless, the Potential Investigation of Pulmonary Embolism Analysis III (PIOPED III) study, a major multicenter trial, found that facilities had problem obtaining sufficient quality MR pulmonary angiography (MRPA) for suspected pulmonary embolism. The PIOPED researchers determined that MRPA must be thought of only at centers that routinely carry out it and carry out it effectively, and for sufferers who've contraindications to straightforward tests.Within the new study, the research crew assessed the impact of two additional MRI sequences on MRPA's accuracy. The 2 strategies--distinction-enhanced volumetric interpolated breath-maintain examination (VIBE) and non-distinction true quick imaging with regular-state precession (true FISP)--complement MRPA, according to Dr. Martin.The addition of VIBE offers a grey scale that enables readers to distinguish between the clot, or thrombus, and the lung, which both appear dark on MRPA.The true FISP take a look at does not require distinction agent or a breath hold, an essential consideration for embolism patients who usually can not maintain their breath lengthy sufficient for picture acquisition on MRPA.When Dr Martin and colleagues studied the three strategies on 22 patients with CTA prognosis of pulmonary embolism, they found a sensitivity of fifty five %, sixty seven % and seventy three % for MRPA, true FISP and VIBE, respectively. Combining all three MRI sequences improved the general detection charge to eighty four percent. Specificity was 100 percent for all detection methods except for MRPA, which demonstrated one false positive.
Outcomes of the research are published on-line within the journal Radiology.
Pulmonary embolism happens when a blood clot--normally from the leg--travels to the lung and blocks the pulmonary artery or one among its most important branches. CT angiography is the gold standard for diagnosis, but it exposes patients to ionizing radiation and iodinated distinction agent, which carries a danger of allergic reactions and kidney injury in some patients."MRI is creating a lot sooner than CT," mentioned Diego R. Martin, M.D., Ph.D., head of the Division of Radiology on the University of Arizona School of Medication in Tucson. "The images we're getting are already significantly higher than they have been a yr ago. There is no doubt that sooner or later we will be able to offer a non-radiation-based mostly various to CT for the analysis of pulmonary embolism."MRI has been used for pulmonary embolism detection in pregnant girls and sufferers whose kidneys may be harmed by CT angiography distinction agents. Nonetheless, the Potential Investigation of Pulmonary Embolism Analysis III (PIOPED III) study, a major multicenter trial, found that facilities had problem obtaining sufficient quality MR pulmonary angiography (MRPA) for suspected pulmonary embolism. The PIOPED researchers determined that MRPA must be thought of only at centers that routinely carry out it and carry out it effectively, and for sufferers who've contraindications to straightforward tests.Within the new study, the research crew assessed the impact of two additional MRI sequences on MRPA's accuracy. The 2 strategies--distinction-enhanced volumetric interpolated breath-maintain examination (VIBE) and non-distinction true quick imaging with regular-state precession (true FISP)--complement MRPA, according to Dr. Martin.The addition of VIBE offers a grey scale that enables readers to distinguish between the clot, or thrombus, and the lung, which both appear dark on MRPA.The true FISP take a look at does not require distinction agent or a breath hold, an essential consideration for embolism patients who usually can not maintain their breath lengthy sufficient for picture acquisition on MRPA.When Dr Martin and colleagues studied the three strategies on 22 patients with CTA prognosis of pulmonary embolism, they found a sensitivity of fifty five %, sixty seven % and seventy three % for MRPA, true FISP and VIBE, respectively. Combining all three MRI sequences improved the general detection charge to eighty four percent. Specificity was 100 percent for all detection methods except for MRPA, which demonstrated one false positive.
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