Pulmonary MRA: differentiation of pulmonary embolism from truncation artefact.
Purpose: Truncation artefact (Gibbs ringing) causes central signal drop within vessels in pulmonary magnetic resonance angiography (MRA) that can be mistaken for emboli, reducing diagnostic accuracy for pulmonary embolism (PE). We propose a quantitative approach to differentiate truncation artefact...
| Publicado en: | European Radiology Vol. 24; no. 8; pp. 1942 - 1950 |
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| Autores principales: | , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Aug2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103832316&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103832316 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Aug2014 vid: 24 iid: 8 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 103832316 103832316 NLM24863886 2012636472 10.1007/s00330-014-3219-5 NLM24863886 PMC4362685 103832316 ppf: 1942 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Pulmonary MRA: differentiation of pulmonary embolism from truncation artefact. aug: au: Bannas, Peter Schiebler, Mark L Motosugi, Utaroh François, Christopher J Reeder, Scott B Nagle, Scott K affil: Department of Radiology, University of Wisconsin-Madison, 600 Highland Avenue, Room E1/372, Madison, WI, 53792-3252, USA, pbannas@uwhealth.org. sug: subj: Artifacts Magnetic Resonance Angiography Methods Pulmonary Artery Pathology Pulmonary Embolism Diagnosis Adult Aged Aged, 80 and Over Contrast Media Diagnostic Use Diagnosis, Differential Female Prospective Studies Human Male Middle Age Multidetector Computed Tomography Methods Pulmonary Artery Radiography ROC Curve Reproducibility of Results Young Adult Adult: 19-44 years Aged: 65+ years Aged, 80 & over Middle Aged: 45-64 years Female Male ab: Purpose: Truncation artefact (Gibbs ringing) causes central signal drop within vessels in pulmonary magnetic resonance angiography (MRA) that can be mistaken for emboli, reducing diagnostic accuracy for pulmonary embolism (PE). We propose a quantitative approach to differentiate truncation artefact from PE.Methods: Twenty-eight patients who underwent pulmonary computed tomography angiography (CTA) for suspected PE were recruited for pulmonary MRA. Signal intensity drops within pulmonary arteries that persisted on both arterial-phase and delayed-phase MRA were identified. The percent signal loss between the vessel lumen and central drop was measured. CTA served as the reference standard for presence of pulmonary emboli.Results: A total of 65 signal intensity drops were identified on MRA. Of these, 48 (74%) were artefacts and 17 (26%) were PE, as confirmed by CTA. Truncation artefacts had a significantly lower median signal drop than PE on both arterial-phase (26% [range 12-58%] vs. 85% [range 53-91%]) and delayed-phase MRA (26% [range 11-55%] vs. 77% [range 47-89%]), p < 0.0001 for both. Receiver operating characteristic (ROC) analyses revealed a threshold value of 51% (arterial phase) and 47% signal drop (delayed phase) to differentiate between truncation artefact and PE with 100% sensitivity and greater than 90% specificity.Conclusion: Quantitative signal drop is an objective tool to help differentiate truncation artefact and pulmonary embolism in pulmonary MRA.Key Points: • Inexperienced readers may mistake truncation artefacts for emboli on pulmonary MRA • Pulmonary emboli have non-uniform signal drop • 51% (arterial phase) and 47% (delayed phase) cut-off differentiates truncation artefact from PE • Quantitative signal drop measurement enables more accurate pulmonary embolism diagnosis with MRA. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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