Gadolinium-enhanced magnetic resonance angiography for detection of acute pulmonary embolism: an in-depth review.
OBJECTIVE
To review the published experience with gadolinium-enhanced magnetic resonance angiography (MRA) for the detection of acute pulmonary embolism (PE) in order to test the hypothesis that gadolinium-enhanced MRA may be potentially sensitive and specific enough to include it among diagnostic alternatives in the evaluation of patients with suspected PE.


METHODS
Studies were identified by searching MEDLINE for trials that used gadolinium-enhanced MRA to diagnose acute PE based on the visualization of an intraluminal filling defect or a cutoff vessel, using pulmonary angiography as a reference standard.


RESULTS
Twenty-eight investigations were identified in which MRA was used to diagnose PE. Only three studies, however, met the criteria for inclusion in the analysis. In these three case series, the sensitivity of gadolinium-enhanced MRA ranged from 77 to 100%, and the specificity ranged from 95 to 98%.


CONCLUSIONS
Gadolinium-enhanced MRA may be a useful diagnostic alternative in some patients with suspected acute PE, particularly if they have an elevated creatinine level, have an allergy to radiographic contrast material, or should, if possible, avoid exposure to ionizing radiation.
Stein
Paul D
PD
St. Joseph Mercy Oakland Hospital, 44555 Woodward Avenue, Suite 107, Pontiac, MI 48341-2985, USA. steinp@trinity-health.org
Woodard
Pamela K
PK
Hull
Russell D
RD
Kayali
Fadi
F
Weg
John G
JG
Olson
Ronald E
RE
Fowler
Sarah E
SE
D000208:Acute Disease; D002986:Clinical Trials as Topic; D016001:Confidence Intervals; D005682:Gadolinium; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D011655:Pulmonary Embolism / Q000175:diagnosis*
D005682:Gadolinium