Magnetic resonance detection of acute pulmonary emboli in a canine model with pathologic correlation.

ABSTRACT

RATIONALE AND OBJECTIVES: The authors evaluated the accuracy of magnetic resonance (MR) imaging in depicting acute pulmonary emboli at the lobar, segmental, and subsegmental levels. METHODS: The authors induced 29 autologous emboli in five dogs and confirmed their location with angiography and anatomic dissection. MR images obtained with four sequences were independently evaluated by two radiologists to detect emboli in each vascular segment. Sensitivities, specificities, and accuracies were calculated at segmental and lobar levels. RESULTS: The fast short-tau inversion-recovery images provided the greatest conspicuity and highest overall accuracy (reader 1 = 74.3%, reader 2 = 80%). Accuracy of two-dimensional fast multiplanar spoiled gradient-recalled-echo images was limited by spatial resolution (reader 1 = 71.4%, reader 2 = 74.3%). The fast spin-echo T2-weighted and spin-echo T1-weighted sequences were intermediate in their depiction of acute emboli. Similar results were seen at the lobar level. CONCLUSION: MR images depict acute pulmonary embolism at the segmental and lobar levels with reasonable accuracy. Fast short-tau inversion-recovery sequences provided the greatest sensitivity and accuracy.