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Pulmonary Embolism

Kostaki G. Bis¹, Anil N. Shetty¹

¹William Beaumont Hospital, Royal Oak, Michigan

Publication Name:

Current Protocols in Magnetic Resonance Imaging

Unit Number:

Unit A13.1

DOI:

10.1002/0471142719.mia1301s02

Online Posting Date:

November, 2001

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Abstract

There have been a number of approaches taken to image the pulmonary vasculature. This unit presents basic protocols based on black blood spin echo and/or gradient echo techniques for detection of pulmonary embolisms and deep vein thrombosis. Bright blood magnetic resonance angiography (MRA), 2-D time-of-flight (TOF), and 3-D contrast-enhanced MRA is also presented for visualizing the entire vascular tree. The parameters provided in this unit are acquired from Siemens 1.5T Vision Scanner. These parameters may need to be altered depending on the field strength and equipment manufacturer.

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Unit Introduction
Basic Protocol 1: Imaging the Pulmonary Arteries with Black Blood Spin Echo and Gradient Echo Techniques
Basic Protocol 2: Contrast Enhanced Pulmonary MRA
Commentary
Bibliography
Figures
Tables

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Materials

Basic Protocol 2: Contrast Enhanced Pulmonary MRA

Materials

Normal saline (0.9 % NaCl), sterile
Extravascular contrast agent (i.e., Magnevist, Omniscan or ProHance)
20-G angio-catheter needle
Power injector

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Figures

Figure A13.1.1

Acute pulmonary thrombo-embolism. Coronal contrast enhanced 3-D gradient echo partitions display central low signal filling defects (arrows) in the left (A) and right (B) interlobar pulmonary arteries.

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Figure A13.1.2

Chronic pulmonary thrombo-embolism. Coronal (A) and sagittal (B) contrast enhanced 3-D gradient echo partitions display low signal organized thrombus (arrows) within the roof of the left pulmonary artery.

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Literature Cited

Literature Cited
	Foo, T.K.F., Manojkumar, S., Prince, M.R., and Chenvert, T.L. 1997. Automated detection of bolus arrival and initiation of data acquisition in fast, three-dimensional gadolinium-enhanced MR angiography. Radiology 203:275-280.
	Hatabu, H., Gefter, W.B., Listerud, J., Hoffman, E.A., Axel, L., McGowan, III, J.C., Palevsku, H.I., Hayes, C.E., Konishi, J., and Kressel, H.Y. 1992. Pulmonary MR angiography utilizing phased-array surface coils. J. Comput. Assist. Tomogr. 16:410-417.
	Kovosec, F.R., Frayne, R., Grist, T.M., and Mistretta, C.A. 1996. Time-resolved contrast-enhanced 3-D-MR angiography. Magn. Reson. Med. 36:345-351.
	Laub, G.A. and Kaiser, W.A. 1988. MR angiography with gradient motion refocusing. J. Comput. Assist. Tomogr. 12:377-382.
	Riederer, S.J., Tasciyan, T., Farzaneh, F., Lee, N.J., Wright, R.C., and Herfkin, R.J. 1988. MR fluoroscopy: Technical feasibility. Magn. Reson. Med. 8:1-15.
	Shellock, F.G. 1997. Pocket Guide to MR Procedures and Metallic Objects. Lippincott-Raven, Philadelphia.
	Shetty, A.N., Shirkhoda, A., Bis, K.G., and Alcantara, A. 1995. Contrast-enhanced three dimensional MR angiography in a single breath-hold: A novel technique. A.J.R. 165:1290-1292.
	Simonetti, O.P., Finn, J.P., White, R.D., Bis, K.G., Shetty, A.N., Tkach, J., Flamm, S., and Laub, G. 1996. ECG-triggered breath-held gadolinium-enhanced 3D MRA of the thoracic vasculature. In Proceedings of the International Society for Magnetic Resonance in Medicine, Vol 2. pp. 703. New York.
	Westbrook, C. and Kaut, C. 1993. MRI in Practice. pp. 154-155. Blackwell Scientific Publications, Oxford.
	Wielopolski, P.A. 1993. Pulmonary Arteriography. In MRI Clinics of North America, Vol 1, No 2. W.A. Saunders, Philadelphia.
	Wielopolski, P.A., Haacke, E.M., and Adler, L.P. 1993. Evaluation of the pulmonary vasculature with three-dimensional magnetic resonance imaging techniques. M.A.G.M.A. 1:21-34.