Literature DB >> 23553735

Effectiveness of MR angiography for the primary diagnosis of acute pulmonary embolism: clinical outcomes at 3 months and 1 year.

Mark L Schiebler1, Scott K Nagle, Christopher J François, Michael D Repplinger, Azita G Hamedani, Karl K Vigen, Rajkumar Yarlagadda, Thomas M Grist, Scott B Reeder.   

Abstract

PURPOSE: To determine the effectiveness of MR angiography for pulmonary embolism (MRA-PE) in symptomatic patients.
MATERIALS AND METHODS: 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.
RESULTS: 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.
CONCLUSION: 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.
Copyright © 2013 Wiley Periodicals, Inc.

Entities:  

Keywords:  effectiveness, outcomes analysis; magnetic resonance angiography; negative predictive value; pulmonary embolism

Mesh:

Year:  2013        PMID: 23553735      PMCID: PMC3970266          DOI: 10.1002/jmri.24057

Source DB:  PubMed          Journal:  J Magn Reson Imaging        ISSN: 1053-1807            Impact factor:   4.813


  49 in total

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2.  Clinical outcomes of patients after a negative spiral CT pulmonary arteriogram in the evaluation of acute pulmonary embolism.

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3.  Clinical validity of helical CT being interpreted as negative for pulmonary embolism: implications for patient treatment.

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Authors:  L R Goodman; R J Lipchik; R S Kuzo; Y Liu; T L McAuliffe; D J O'Brien
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5.  Risk of pulmonary embolism after a negative spiral CT angiogram in patients with pulmonary disease: 1-year clinical follow-up study.

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Authors:  A Perrier; N Howarth; D Didier; P Loubeyre; P F Unger; P de Moerloose; D Slosman; A Junod; H Bounameaux
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Authors:  M P Revel; O Sanchez; S Couchon; B Planquette; A Hernigou; R Niarra; G Meyer; G Chatellier
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Journal:  Radiology       Date:  1999-02       Impact factor: 11.105

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Journal:  BMJ       Date:  2012-09-06
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Review 2.  Cardiac Applications of PET-MR.

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Review 3.  Contrast-enhanced pulmonary MRA for the primary diagnosis of pulmonary embolism: current state of the art and future directions.

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4.  Pulmonary MRA: differentiation of pulmonary embolism from truncation artefact.

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Review 8.  Contrast enhanced pulmonary magnetic resonance angiography for pulmonary embolism: Building a successful program.

Authors:  Scott K Nagle; Mark L Schiebler; Michael D Repplinger; Christopher J François; Karl K Vigen; Rajkumar Yarlagadda; Thomas M Grist; Scott B Reeder
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Review 10.  Magnetic resonance and computed tomography imaging of the structural and functional changes of pulmonary arterial hypertension.

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