Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
J Magn Reson Imaging. 2013 Oct;38(4):914-25. doi: 10.1002/jmri.24057. Epub 2013 Apr 1.
To determine the effectiveness of MR angiography for pulmonary embolism (MRA-PE) in symptomatic patients.
We retrospectively reviewed all patients whom were evaluated for possible pulmonary embolism (PE) using MRA-PE. A 3-month and 1-year from MRA-PE electronic medical record (EMR) review was performed. Evidence for venous thromboembolism (VTE) (or death from PE) within the year of follow-up was the outcome surrogate for this study.
There were 190 MRA-PE exams performed with 97.4% (185/190) of diagnostic quality. There were 148 patients (120 F: 28 M) that had both a diagnostic MRA-PE exam and 1 complete year of EMR follow-up. There were 167 patients (137 F: 30 M) with 3 months or greater follow-up. We found 83% (139/167) and 81% (120/148) MRA-PE exams negative for PE at 3 months and 1 year, respectively. Positive exams for PE were seen in 14% (23/167). During the 1-year follow-up period, five patients (false negative) were diagnosed with DVT (5/148 = 3.4 %), and one of these patients also experienced a non-life-threatening PE. The negative predictive value (NPV) for MRA-PE was 97% (92-99; 95% CI) at 3 months and 96% (90-98; 95% CI) with 1 year of follow-up.
The NPV of MRA-PE, when used for the primary diagnosis of pulmonary embolism in symptomatic patients, were found to be similar to the published values for CTA-PE. In addition, the technical success rate and safety of MRA-PE were excellent.
确定磁共振血管造影（MRA-PE）在有症状患者中诊断肺栓塞（PE）的有效性。
我们回顾性分析了所有因疑似肺栓塞（PE）而接受 MRA-PE 检查的患者。对 MRA-PE 电子病历（EMR）进行了 3 个月和 1 年的随访。本研究的替代终点为随访年内静脉血栓栓塞症（VTE）（或因 PE 死亡）的证据。
共进行了 190 次 MRA-PE 检查，其中 97.4%（185/190）为诊断质量。148 例患者（120 例女性：28 例男性）接受了诊断性 MRA-PE 检查和 1 年完整的 EMR 随访。167 例患者（137 例女性：30 例男性）随访时间超过 3 个月。我们发现，3 个月和 1 年时 MRA-PE 检查对 PE 的阴性预测值分别为 83%（139/167）和 81%（120/148）。PE 阳性检查占 14%（23/167）。在 1 年随访期间，5 例患者（假阴性）诊断为深静脉血栓形成（DVT）（5/148=3.4%），其中 1 例患者还发生了非危及生命的 PE。MRA-PE 的阴性预测值（NPV）在 3 个月时为 97%（92-99；95%CI），1 年时为 96%（90-98；95%CI）。
在有症状患者中，MRA-PE 用于诊断肺栓塞的 NPV 与 CTA-PE 的已发表值相似。此外，MRA-PE 的技术成功率和安全性非常出色。
