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

作     者：Nanae Tsuchiya Edwin JR van Beek Yoshiharu Ohno Hiroto Hatabu Hans-Ulrich Kauczor Andrew Swift Jens Vogel-Claussen Jürgen Biederer James Wild Mark O Wielpütz Mark L Schiebler 

作者机构：Department of Radiology Graduate School of Medical Science University of the Ryukyus Department of Radiology University of Wisconsin-Madison Edinburgh Imaging Queen’s Medical Research Institute University of Edinburgh Division of Functional and Diagnostic Imaging Research Department of Radiology Kobe University Graduate School of Medicine Department of Radiology Brigham and Women’s Hospital Department of Diagnostic and Interventional Radiology University Hospital of Heidelberg Department of Radiology Royal Hallamshire Hospital University of Sheffield Department of Radiology Carl-Neuberg Strasse 1 Radiology Darmstadt Gross-Gerau County Hospital Department of Infection Immunity and Cardiovascular Disease University of Sheffield 

出 版 物：《World Journal of Radiology》 (世界放射学杂志（英文版）（电子版）)

年 卷 期：2018年第10卷第6期

页      面：52-64页

学科分类：10[医学] 

基　　金：research support of the Department of Radiology UW-Madison and GE Healthcare 

主　　题：Female Lung Neoplasms Hypersensitivity Pulmonary embolism Magnetic resonance angiography Radiation induced Outcome assessment(health care) Artifacts Computerized tomography angiography 

摘      要：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 CEMRA and the appropriate imaging scenarios for the primary diagnosis of PE derived from our unique multiinstitutional 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.