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Diagnostic accuracy of contrast-enhanced MR angiography and unenhanced proton MR imaging compared with CT pulmonary angiography in chronic thromboembolic pulmonary hypertension

Abstract

To evaluate the diagnostic accuracy of contrast-enhanced MR angiography (CE-MRA) and the added benefit of unenhanced proton MR angiography compared with CT pulmonary angiography (CTPA) in patients with chronic thromboembolic disease (CTE). A 2 year retrospective study of 53 patients with chronic thromboembolic pulmonary hypertension who underwent CTPA and MRI for suspected pulmonary hypertension and a control group of 36 patients with no CT evidence of pulmonary embolism. The MRI was evaluated for CTE and the combined diagnostic accuracy of ce-MRA and unenhanced proton MRA was determined. CE-MRA generated lung perfusion maps were also assessed. The overall sensitivity and specificity of CE-MRA in diagnosing proximal and distal CTE were 98% and 94%, respectively. The sensitivity improved from 50% to 88% for central vessel disease when CE-MRA images were analysed with unenhanced proton MRA. The CE-MRA identified more stenoses (29/18), post-stenosis dilatation (23/7) and occlusions (37/29) compared with CTPA. The CE-MRA perfusion images showed a sensitivity of 92% for diagnosing CTE. CE-MRA has high sensitivity and specificity for diagnosing CTE. The sensitivity of CE-MRA for visualisation of adherent central and lobar thrombus significantly improves with the addition of unenhanced proton MRA which delineates the vessel wall. (orig.)
Authors:
Rajaram, Smitha; [1]  Academic Unit of Radiology, C Floor, Royal Hallamshire Hospital, Sheffield (United Kingdom)]; Swift, Andrew J; Wild, Jim M; [1]  Sheffield Cardiovascular Biomedical Research Unit, Sheffield (United Kingdom)]; Capener, David; Telfer, Adam; [1]  Davies, Christine; Hill, Catherine; [2]  Condliffe, Robin; Elliot, Charles; Kiely, David G; [3]  Sheffield Cardiovascular Biomedical Research Unit, Sheffield (United Kingdom)]; Hurdman, Judith [3] 
  1. Unit of Academic Radiology, University of Sheffield, Sheffield (United Kingdom)
  2. Sheffield Teaching Hospitals Trust, Department of Radiology, Sheffield (United Kingdom)
  3. Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield (United Kingdom)
Publication Date:
Feb 15, 2012
Product Type:
Journal Article
Resource Relation:
Journal Name: European Radiology; Journal Volume: 22; Journal Issue: 2
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ACCURACY; BIOMEDICAL RADIOGRAPHY; BLOOD FLOW; BLOOD VESSELS; COMPUTERIZED TOMOGRAPHY; CONTRAST MEDIA; DIAGNOSIS; EMBOLI; HYPERTENSION; LUNGS; NMR IMAGING; PERFUSED ORGANS; SENSITIVITY; SPECIFICITY; THROMBOSIS
OSTI ID:
21545120
Country of Origin:
Germany
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0938-7994; EURAE3; TRN: DE12F4763
Availability:
Available from: http://dx.doi.org/10.1007/s00330-011-2252-x
Submitting Site:
DEN
Size:
page(s) 310-317
Announcement Date:
Apr 12, 2012

Citation Formats

Rajaram, Smitha, Academic Unit of Radiology, C Floor, Royal Hallamshire Hospital, Sheffield (United Kingdom)], Swift, Andrew J, Wild, Jim M, Sheffield Cardiovascular Biomedical Research Unit, Sheffield (United Kingdom)], Capener, David, Telfer, Adam, Davies, Christine, Hill, Catherine, Condliffe, Robin, Elliot, Charles, Kiely, David G, Sheffield Cardiovascular Biomedical Research Unit, Sheffield (United Kingdom)], and Hurdman, Judith. Diagnostic accuracy of contrast-enhanced MR angiography and unenhanced proton MR imaging compared with CT pulmonary angiography in chronic thromboembolic pulmonary hypertension. Germany: N. p., 2012. Web. doi:10.1007/S00330-011-2252-X.
Rajaram, Smitha, Academic Unit of Radiology, C Floor, Royal Hallamshire Hospital, Sheffield (United Kingdom)], Swift, Andrew J, Wild, Jim M, Sheffield Cardiovascular Biomedical Research Unit, Sheffield (United Kingdom)], Capener, David, Telfer, Adam, Davies, Christine, Hill, Catherine, Condliffe, Robin, Elliot, Charles, Kiely, David G, Sheffield Cardiovascular Biomedical Research Unit, Sheffield (United Kingdom)], & Hurdman, Judith. Diagnostic accuracy of contrast-enhanced MR angiography and unenhanced proton MR imaging compared with CT pulmonary angiography in chronic thromboembolic pulmonary hypertension. Germany. https://doi.org/10.1007/S00330-011-2252-X
Rajaram, Smitha, Academic Unit of Radiology, C Floor, Royal Hallamshire Hospital, Sheffield (United Kingdom)], Swift, Andrew J, Wild, Jim M, Sheffield Cardiovascular Biomedical Research Unit, Sheffield (United Kingdom)], Capener, David, Telfer, Adam, Davies, Christine, Hill, Catherine, Condliffe, Robin, Elliot, Charles, Kiely, David G, Sheffield Cardiovascular Biomedical Research Unit, Sheffield (United Kingdom)], and Hurdman, Judith. 2012. "Diagnostic accuracy of contrast-enhanced MR angiography and unenhanced proton MR imaging compared with CT pulmonary angiography in chronic thromboembolic pulmonary hypertension." Germany. https://doi.org/10.1007/S00330-011-2252-X.
@misc{etde_21545120,
title = {Diagnostic accuracy of contrast-enhanced MR angiography and unenhanced proton MR imaging compared with CT pulmonary angiography in chronic thromboembolic pulmonary hypertension}
author = {Rajaram, Smitha, Academic Unit of Radiology, C Floor, Royal Hallamshire Hospital, Sheffield (United Kingdom)], Swift, Andrew J, Wild, Jim M, Sheffield Cardiovascular Biomedical Research Unit, Sheffield (United Kingdom)], Capener, David, Telfer, Adam, Davies, Christine, Hill, Catherine, Condliffe, Robin, Elliot, Charles, Kiely, David G, Sheffield Cardiovascular Biomedical Research Unit, Sheffield (United Kingdom)], and Hurdman, Judith}
abstractNote = {To evaluate the diagnostic accuracy of contrast-enhanced MR angiography (CE-MRA) and the added benefit of unenhanced proton MR angiography compared with CT pulmonary angiography (CTPA) in patients with chronic thromboembolic disease (CTE). A 2 year retrospective study of 53 patients with chronic thromboembolic pulmonary hypertension who underwent CTPA and MRI for suspected pulmonary hypertension and a control group of 36 patients with no CT evidence of pulmonary embolism. The MRI was evaluated for CTE and the combined diagnostic accuracy of ce-MRA and unenhanced proton MRA was determined. CE-MRA generated lung perfusion maps were also assessed. The overall sensitivity and specificity of CE-MRA in diagnosing proximal and distal CTE were 98% and 94%, respectively. The sensitivity improved from 50% to 88% for central vessel disease when CE-MRA images were analysed with unenhanced proton MRA. The CE-MRA identified more stenoses (29/18), post-stenosis dilatation (23/7) and occlusions (37/29) compared with CTPA. The CE-MRA perfusion images showed a sensitivity of 92% for diagnosing CTE. CE-MRA has high sensitivity and specificity for diagnosing CTE. The sensitivity of CE-MRA for visualisation of adherent central and lobar thrombus significantly improves with the addition of unenhanced proton MRA which delineates the vessel wall. (orig.)}
doi = {10.1007/S00330-011-2252-X}
journal = []
issue = {2}
volume = {22}
place = {Germany}
year = {2012}
month = {Feb}
}