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MR Angiography with Sensitivity Encoding (SENSE) for Suspected Pulmonary Embolism: Comparison with MDCT and Ventilation–Perfusion Scintigraphy

Yoshiharu Ohno1, Takanori Higashino1, Daisuke Takenaka2, Kouji Sugimoto1, Takeshi Yoshikawa1, Hiroya Kawai3, Masahiko Fujii1, Hiroto Hatabu1,4 and Kazuro Sugimura1

1 Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
2 Department of Radiology, Kasai Municipal Hospital, 1-13, Yokoo Hojo-chou, Kasai, Hyogo 675-2312, Japan.
3 Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe 650-0017, Japan.
4 Present address: Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02115.



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  		Fig. 1A. —45-year-old woman with acute pulmonary embolism. Contrast-enhanced MDCT scans show thrombi (arrows) in anterior truncus, right interlobar artery, middle and lower lobe pulmonary arteries, left pulmonary artery, left upper lobe trunk, and descending trunk on left.

 


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  		Fig. 1B. —45-year-old woman with acute pulmonary embolism. Source images of time-resolved contrast-enhanced MR angiography using SENSE reveal thrombi (arrows) in anterior truncus, right interlobar artery, left pulmonary artery, left upper lobe trunk, and descending trunk on left, and perfusion defect (small arrowheads) in left superior segment of lower lobe. Reduced pulmonary blood flow (large arrowheads) in right middle and lower lobes indicates high probability of pulmonary embolism in right middle and lower lobe pulmonary arteries.

 


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  		Fig. 1C. —45-year-old woman with acute pulmonary embolism. Perfusion scintigraphic image shows heterogeneous perfusion defects in both lungs.

 


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  		Fig. 2. —Receiver operating characteristic curves of data sets per vascular zone. Areas under curves of data sets A, B, and C are 0.96, 0.94, and 0.96, respectively. Per–vascular zone diagnostic capability of data set A was slightly better than that of data set B and was equal to that of data set C. {square} = time-resolved contrast-enhanced MR angiography alone (data set A), {blacksquare} = contrast-enhanced MDCT alone (data set B), {blacksquare} = contrast-enhanced MDCT with time-resolved contrast-enhanced MR angiography (data set C).

 


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  		Fig. 3. —Receiver operating characteristic curves of data sets per patient. Areas under curves were as follows: data set A = 0.97, B = 0.92, C = 0.97, D = 0.70, and E = 0.97. Diagnostic capability of data set A was significantly better than that of data set D (p < 0.05) and was equal to that of data sets C and E. {square} = time-resolved contrast-enhanced MR angiography alone (data set A), {circ} = contrast-enhanced MDCT alone (data set B); {blacksquare} = contrast-enhanced MDCT with time-resolved contrast-enhanced MR angiography (data set C), {blacktriangleup} = ventilation–perfusion scintigraphy (data set D), = contrast-enhanced MDCT with ventilation–perfusion scintigraphy (data set E).

 

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