TY - JOUR
T1 - Dynamic MR perfusion imaging
T2 - Capability for quantitative assessment of disease extent and prediction of outcome for patients with acute pulmonary thromboembolism
AU - Ohno, Yoshiharu
AU - Koyama, Hisanobu
AU - Matsumoto, Keiko
AU - Onishi, Yumiko
AU - Nogami, Munenobu
AU - Takenaka, Daisuke
AU - Yoshikawa, Takeshi
AU - Matsumoto, Sumiaki
AU - Sugimura, Kazuro
N1 - Copyright:
Copyright 2010 Elsevier B.V., All rights reserved.
PY - 2010/5
Y1 - 2010/5
N2 - Purpose: To compare directly the capabilities of multidetector-row computed tomography (MDCT) and MRI for disease severity assessment and outcome prediction for acute pulmonary thromboembolism (APTE) patients. Materials and Methods: Fifty consecutive APTE patients underwent MDCT, MR angiography, dynamic perfusion MRI, treatment and follow-up examination. Pulmonary blood flow (PBF), pulmonary blood volume, and mean transit time maps were generated from perfusion MRI, and all segmental parameters were determined by using region of interest measurements. Receiver operator curve analyses were used to determine the most accurate parameter for diagnosis of the APTE segment. Then, APTE index from perfusion MRI (PEperfusion MRI index), right ventricle/left ventricle (RV/LV) diameter ratio and APTE indexes from embolic burdens observed on MDCT (PECT index) and MR angiography (PEMRA index) were calculated. Finally, ability to differentiate mortality (n = 8) from survival (n = 42) groups and to predict patient outcome were statistically assessed. Results: PBF was a significantly more accurate parameter than others (P < 0.05). When feasible threshold value was applied, specificity and accuracy of RV/LV diameter ratio and PEPerfusion MRI index were significantly higher than those of PECT and PEMRA indexes (P < 0.05). Logistic regression analysis demonstrated that each index was a significant predictor (P < 0.05). Conclusion: Dynamic perfusion MRI can be effective for disease extent assessment and outcome prediction for APTE patients.
AB - Purpose: To compare directly the capabilities of multidetector-row computed tomography (MDCT) and MRI for disease severity assessment and outcome prediction for acute pulmonary thromboembolism (APTE) patients. Materials and Methods: Fifty consecutive APTE patients underwent MDCT, MR angiography, dynamic perfusion MRI, treatment and follow-up examination. Pulmonary blood flow (PBF), pulmonary blood volume, and mean transit time maps were generated from perfusion MRI, and all segmental parameters were determined by using region of interest measurements. Receiver operator curve analyses were used to determine the most accurate parameter for diagnosis of the APTE segment. Then, APTE index from perfusion MRI (PEperfusion MRI index), right ventricle/left ventricle (RV/LV) diameter ratio and APTE indexes from embolic burdens observed on MDCT (PECT index) and MR angiography (PEMRA index) were calculated. Finally, ability to differentiate mortality (n = 8) from survival (n = 42) groups and to predict patient outcome were statistically assessed. Results: PBF was a significantly more accurate parameter than others (P < 0.05). When feasible threshold value was applied, specificity and accuracy of RV/LV diameter ratio and PEPerfusion MRI index were significantly higher than those of PECT and PEMRA indexes (P < 0.05). Logistic regression analysis demonstrated that each index was a significant predictor (P < 0.05). Conclusion: Dynamic perfusion MRI can be effective for disease extent assessment and outcome prediction for APTE patients.
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U2 - 10.1002/jmri.22146
DO - 10.1002/jmri.22146
M3 - Article
C2 - 20432342
AN - SCOPUS:77951607331
SN - 1053-1807
VL - 31
SP - 1081
EP - 1090
JO - Journal of Magnetic Resonance Imaging
JF - Journal of Magnetic Resonance Imaging
IS - 5
ER -