Abstract
In a multi-center trial, gadolinium enhanced magnetic resonance angiography (MRA) for diagnosis of acute pulmonary embolism (PE) had a high rate of technically inadequate images. Accordingly, we evaluated the reasons for poor quality MRA of the pulmonary arteries in these patients. We performed a retrospective analysis of the data collected in the PIOPED III study. We assessed the relationship to the proportion of examinations deemed “uninterpretable” by central readers to the clinical centers, MR equipment platform and vendors, degree of vascular opacification in different orders of pulmonary arteries; type, frequency and severity of image artifacts; patient co-morbidities, symptoms and signs; and reader characteristics. Centers, MR equipment vendor and platform, degree of vascular opacification, and motion artifacts influenced the likelihood of central reader determinations that images were “uninterpretable”. Neither the reader nor patient characteristics (age, body mass index, respiratory rate, heart rate) correlated with the likelihood of determining examinations “uninterpretable”. Vascular opacification and motion artifact are the principal factors influencing MRA interpretability. Some centers obtain better images more consistently, but the reasons for differences between centers are unclear.
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Acknowledgments
This study was supported by Grants HL081593, HL177150, HL077149, HL077151, HL077154, HL081594, HL077358, HL077155, and HL077153 from the U.S. Department of Health and Human Services, Public Health Services, National Heart, Lung, and Blood Institute, Bethesda, Maryland.
Conflict of interest
Dr. Woodard received research support from GE Healthcare and Siemens Medical Systems.
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Dirk Sostman, H., Jablonski, K.A., Woodard, P.K. et al. Factors in the technical quality of gadolinium enhanced magnetic resonance angiography for pulmonary embolism in PIOPED III. Int J Cardiovasc Imaging 28, 303–312 (2012). https://doi.org/10.1007/s10554-011-9820-7
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DOI: https://doi.org/10.1007/s10554-011-9820-7