Feasibility of post-gadolinium three-dimensional gradient-echo sequence to evaluate the pulmonary arterial vasculature

Abstract 

Purpose

To determine the feasibility of post-gadolinium three-dimensional gradient-echo (3D-GE) sequence for the evaluation of the pulmonary arterial vasculature in patients with suspected pulmonary embolism (PE) and in patients with a variety of other disease processes.

Materials and Methods

Twenty-six consecutive patients (18 females, 8 males; mean age±S.D., 46.6±21.1 years) who underwent chest magnetic resonance imaging (MRI) including post-gadolinium 3D-GE sequence for the evaluation of PE (Group A, n=13) and a variety of other disease processes (Group B, n=13) were included in the study. Post-gadolinium 3D-GE MR sequences were retrospectively, independently and blindly evaluated by two reviewers for the image quality of pulmonary arterial vasculature, and findings of PE and other disease processes. Clinical and imaging follow-up data for all patients were obtained. Interobserver agreement was calculated by kappa statistics.

Results

All central and lobar pulmonary arteries, 71.4–89.6% of segmental arteries and 46.7–52.7% of subsegmental arterial units in both groups were visualized with sufficient diagnostic image quality on post-gadolinium 3D-GE sequences. PE involving lobar and segmental arteries was diagnosed in two patients in each group. Other disease processes including pneumonia, lung nodules, superior vena cava stenosis, lung metastases, chronic lymphocytic leukemia and aortic aneurysm were detected in 10 of 26 patients. There was good to excellent interobserver agreement (0.73 to 1.00) for all findings.

Conclusion

Post-gadolinium 3D-GE sequence may be an alternative technique for the visualization of central, lobar and segmental arteries, and may diagnose PE and other pathologies involving the chest in different patient populations.

Keywords: Pulmonary arteries, Pulmonary embolism, Post-gadolinium, 3D Gradient echo, MRI