Pulmonary Embolism Clinical Trial
Official title:
Role of MRI in Diagnosis of Pulmonary Embolism
The aim of this work is to emphasize the role of non-contrast MR imaging in diagnosis of acute pulmonary embolism in comparison to CTA and contrast enhanced MRA as gold standard techniques.
Pulmonary embolism (PE) is a serious condition responsible for significant morbidity and
mortality. PE is currently the third leading cause of cardiovascular death worldwide, so it
requires prompt diagnosis and treatment to prevent potentially deadly consequences (1) .
Pulmonary embolism occurs when a blood clot—usually from the leg—travels to the lung and
blocks the pulmonary artery or one of its branches (2). The diagnosis of acute PE is
considered a clinical dilemma due to wide spectrum of multiple nonspecific signs and symptoms
(3) .
The D-dimer results are of bad positive laboratory test being positive in other situations
rather than PE such as cancer and inflammation (4) .
CT pulmonary angiography (CTA) is highly sensitive and specific for the diagnosis of PE and
has become the imaging method of choice in patients suspected of having PE. The multislice CT
offered high spatial and temporal resolution imaging in a short time scan. CTA has the
ability to assess the pulmonary tree down to the fifth and to eighth order branches in less
than 15 seconds due to high speed (5).
However, Limitations of CTPA include exposure to ionizing radiation with its risk of cancer
induction and iodinated contrast agent, which carries a risk of allergic reactions and kidney
damage and failure in some patients (6) .Many patients with suspected PE, such as pregnant
women and patients with impaired renal function, have at least a relative contraindication to
contrast media irradiation.
MRI offers a potential alternative to CTPA in the evaluation of the pulmonary vasculature and
the diagnosis of PE [7]. To date, however, the majority of studies evaluating the use of MRI
in the diagnosis of PE have used gadolinium based intravenous contrast media, which is
contraindicated in pregnant patients and in those with renal failure [8].
So, alternatively non contrast MRA improves diagnostic accuracy and simplify the acquisition
techniques remains an area of clinically important development. The non-contrast MRA produces
enhancing signal from the vessel wall, provides high contrast with no need for bolus timing
and provides motion-insensitivity to respiration (9).
The purpose of this study to evaluate the feasibility of detecting pulmonary emboli using non
contrast bright blood and dark blood MR imaging techniques.
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