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J Magn Reson Imaging. 2013 Oct;38(4):914-25. doi: 10.1002/jmri.24057. Epub 2013 Apr 1.

Effectiveness of MR angiography for the primary diagnosis of acute pulmonary embolism: clinical outcomes at 3 months and 1 year.

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  • 1Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.

Abstract

PURPOSE:

To determine the effectiveness of MR angiography for pulmonary embolism (MRA-PE) in symptomatic patients.

MATERIALS AND METHODS:

We retrospectively reviewed all patients whom were evaluated for possible pulmonary embolism (PE) using MRA-PE. A 3-month and 1-year from MRA-PE electronic medical record (EMR) review was performed. Evidence for venous thromboembolism (VTE) (or death from PE) within the year of follow-up was the outcome surrogate for this study.

RESULTS:

There were 190 MRA-PE exams performed with 97.4% (185/190) of diagnostic quality. There were 148 patients (120 F: 28 M) that had both a diagnostic MRA-PE exam and 1 complete year of EMR follow-up. There were 167 patients (137 F: 30 M) with 3 months or greater follow-up. We found 83% (139/167) and 81% (120/148) MRA-PE exams negative for PE at 3 months and 1 year, respectively. Positive exams for PE were seen in 14% (23/167). During the 1-year follow-up period, five patients (false negative) were diagnosed with DVT (5/148 = 3.4 %), and one of these patients also experienced a non-life-threatening PE. The negative predictive value (NPV) for MRA-PE was 97% (92-99; 95% CI) at 3 months and 96% (90-98; 95% CI) with 1 year of follow-up.

CONCLUSION:

The NPV of MRA-PE, when used for the primary diagnosis of pulmonary embolism in symptomatic patients, were found to be similar to the published values for CTA-PE. In addition, the technical success rate and safety of MRA-PE were excellent.

Copyright © 2013 Wiley Periodicals, Inc.

KEYWORDS:

effectiveness, outcomes analysis; magnetic resonance angiography; negative predictive value; pulmonary embolism

PMID:
23553735
[PubMed - indexed for MEDLINE]
PMCID:
PMC3970266
Free PMC Article

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