Experience in 207 combined MRI examinations for acute pulmonary embolism and deep vein thrombosis
Experience in 207 combined MRI examinations for acute pulmonary embolism and deep vein thrombosis
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DOI：
10.2214/ajr.05.0756
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发表时间：
2006-06-01
影响因子：
5
通讯作者：
Bachmann, G
中科院分区：
文献类型：
--
作者：
Kluge, A;Mueller, C;Bachmann, G
OBJECTIVE.本研究的目的是前瞻性评估的可行性和质量的联合MRI检查，包括胸部MRI的可疑肺栓塞（PE）和MR静脉造影深静脉血栓形成（DVT），以评估诊断率的联合检查检测血栓栓塞相比，每个组件单独，并回顾性评估的一致性双功能超声和MR静脉造影。221例疑似PE的连续患者（119例男性，102例女性;平均年龄51岁;范围31-86岁）采用多技术胸部MRI方案（使用稳态进动真快速成像[FISP]的实时MRI、灌注MRI和MR血管造影）进行检查，随后进行步进式MR静脉造影。进行了221次胸部MRI检查。计划进行218次MR静脉造影检查，其中5次（2.3%）由于临床或技术原因未进行，6次在胸部MRI阴性后未进行。在207次联合检查中，PE诊断为76例，DVT诊断为78例。13例无PE的患者显示DVT;因此，MR静脉造影检测到17%的额外血栓栓塞病例。与双功超声的一致性在大腿处较好（kappa = 0.87-0.89），但在骨盆处中等（kappa = 0.59-0.65）。PE和DVT的“一站式”MRI联合检查是常规可行的，与单独检查相比，可多检出17%的血栓栓塞病例。MRI可被视为避免CT禁忌症的二线技术，但也是诊断血栓栓塞的主要综合技术。
OBJECTIVE. The purpose of this study was to prospectively assess the feasibility and quality of combined MRI examinations consisting of thoracic MRI for suspected pulmonary embolism (PE) and MR venography for deep vein thrombosis (DVT), to assess the diagnostic yield of a combined examination for detecting thromboembolism compared with each component alone, and to retrospectively assess the concordance of duplex sonography and MR venography.SUBJECTS AND METHODS. Two hundred twenty-one consecutive patients (119 men, 102 women; mean age, 51 years; range, 31-86 years) with suspected PE were examined using a multitechnique thoracic MRI protocol (real-time MRI using true fast imaging with steady-state precession [FISP], perfusion MRI, and MR angiography) followed by stepping-table MR venography.RESULTS. Two hundred twenty-one thoracic MRI examinations were per-formed. Two hundred eighteen MR venography examinations were scheduled, of which five (2.3%) were not per-formed for clinical or technical reasons and six were not performed after negative thoracic MRI. Among 207 combined examinations, PE was diagnosed in 76 and DVT in 78 examinations. Thirteen patients without PE showed DVT; thus, MR venography detected 17% additional cases of thromboembolism. Agreement with duplex sonography was good at the upper leg (kappa = 0.87-0.89) but moderate at the pelvis (kappa = 0.59-0.65).CONCLUSION. A combined "one-stop-shopping" MRI approach for PE and DVT was routinely feasible and detected 17% more cases of thromboembolism compared with separate examinations. MRI may be considered a second-line technique to avoid contraindications to CT but also a primary comprehensive technique for diagnosing thromboembolism.