Aghayev Ayaz, Memon Aliza A, Greenough Paul Gregg, Nayak Lakshmi, Zheng Sijie, Siedlecki Andrew M
Brigham and Women's Hospital, Department of Radiology, Boston, Massachusetts.
Brigham and Women's Hospital, Department of Internal Medicine, Boston, Massachusetts.
Clin Pract Cases Emerg Med. 2020 Aug;4(3):308-311. doi: 10.5811/cpcem.2020.5.46517.
Ferumoxytol-enhanced magnetic resonance angiography (FeMRA) can be used as an alternate and safe method to diagnose patients with compromised renal function who present with acute pulmonary embolus in the emergency department (ED) setting.
A 62-year old man with a history of renal transplant and lymphoproliferative disease described new onset of breathlessness. His clinical symptoms were suggestive of pulmonary embolus. He underwent FeMRA in the ED to avoid exposure to intravenous iodinated contrast. FeMRA demonstrated a left main pulmonary artery embolus, which extended to the left interlobar pulmonary artery. Afterward, the patient initiated anticoagulation therapy. With preserved renal function he was able to continue his outpatient chemotherapy regimen.
This case highlights a safe imaging technique for emergency physicians to diagnose pulmonary embolus and subsequently guide anticoagulation therapy for patients in whom use of conventional contrast is contraindicated.
铁羧麦芽糖增强磁共振血管造影（FeMRA）可作为一种替代且安全的方法，用于诊断在急诊科（ED）出现急性肺栓塞且肾功能受损的患者。
一名62岁男性，有肾移植和淋巴增殖性疾病史，自述新发呼吸困难。其临床症状提示肺栓塞。他在急诊科接受了FeMRA检查，以避免接触静脉注射碘造影剂。FeMRA显示左主肺动脉栓塞，延伸至左叶间肺动脉。之后，患者开始抗凝治疗。由于肾功能保留，他能够继续其门诊化疗方案。
本病例突出了一种安全的成像技术，可供急诊医生用于诊断肺栓塞，并随后指导对禁忌使用传统造影剂的患者进行抗凝治疗。
