Pasin Lilian, Zanon Matheus, Moreira Jose, Moreira Ana Luiza, Watte Guilherme, Marchiori Edson, Hochhegger Bruno
Department of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Av. Independência, 75, Porto Alegre, 90020-160, Brazil.
Department of Clinical Medicine, Federal University of Health Sciences of Porto Alegre, R. Sarmento Leite, 245, Porto Alegre, 90050-170, Brazil.
Lung. 2017 Apr;195(2):193-199. doi: 10.1007/s00408-017-9975-7. Epub 2017 Jan 23.
We evaluated the diagnostic value for pulmonary embolism (PE) of the True fast imaging with steady-state precession (TrueFISP) MRI, a method that allows the visualization of pulmonary vasculature without breath holding or intravenous contrast.
This is a prospective investigation including 93 patients with suspected PE. All patients underwent TrueFISP MRI after undergoing CT pulmonary angiography (CTPA). Two independent readers evaluated each MR study, and consensus was obtained. CTPA results were analysed by a third independent reviewer and these results served as the reference standard. A fourth radiologist was responsible for evaluating if lesions found on MRI for both analysis were the same and if these were the correspondent lesions on the CTPA. Sensitivity, specificity, predictive values and accuracy were calculated. Evidence for death from PE within the 1-year follow-up was also assessed.
Two patients could not undergo the real-time MRI and were excluded from the study. PE prevalence was 22%. During the 1-year follow-up period, eight patients died, whereas PE was responsible for 12.5% of cases. Between patients who developed PE, only 5% died due to this condition. There were no differences between MR and CT embolism detection in these subjects. MR sequences had a sensitivity of 85%, specificity was 98.6% and accuracy was 95.6%. Agreement between readers was high (κ= 0.87).
Compared with contrast-enhanced CT, unenhanced MR sequences demonstrate good accuracy and no differences in the mortality rates in 1 year were detected.
我们评估了稳态进动快速成像（TrueFISP）MRI对肺栓塞（PE）的诊断价值，该方法无需屏气或静脉注射造影剂即可显示肺血管系统。
这是一项前瞻性研究，纳入了93例疑似PE患者。所有患者在接受胸部CT血管造影（CTPA）后均接受了TrueFISP MRI检查。由两名独立的阅片者评估每项MR研究，并达成共识。CTPA结果由第三位独立的审阅者进行分析，这些结果作为参考标准。第四名放射科医生负责评估MRI上发现的病变在两次分析中是否相同，以及这些病变是否与CTPA上的相应病变一致。计算敏感性、特异性、预测值和准确性。还评估了1年随访期间PE死亡的证据。
两名患者无法进行实时MRI检查，被排除在研究之外。PE患病率为22%。在1年的随访期内，8例患者死亡，其中PE导致的死亡占12.5%。在发生PE的患者中，只有5%死于这种疾病。在这些受试者中，MR和CT对栓塞的检测没有差异。MR序列的敏感性为85%，特异性为98.6%，准确性为95.6%。阅片者之间的一致性较高（κ=0.87）。
与增强CT相比，非增强MR序列显示出良好的准确性，且在1年内未检测到死亡率的差异。
