title: Factors in the technical quality of gadolinium enhanced magnetic resonance angiography for pulmonary embolism in PIOPED III.
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.
authors.affiliation: Office of the Dean and Department of Radiology, Weill Cornell Medical College and The Methodist Hospital, Houston, Texas, USA.
authors.forename: H Dirk
authors.initials: HD
authors.lastname: Sostman
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Jablonski
authors.forename: Pamela K
authors.initials: PK
authors.lastname: Woodard
authors.forename: Paul D
authors.initials: PD
authors.lastname: Stein
authors.forename: David P
authors.initials: DP
authors.lastname: Naidich
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Chenevert
authors.forename: John G
authors.initials: JG
authors.lastname: Weg
authors.forename: Charles A
authors.initials: CA
authors.lastname: Hales
authors.forename: Russell D
authors.initials: RD
authors.lastname: Hull
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Goodman
authors.forename: Victor F
authors.initials: VF
authors.lastname: Tapson
mesh_terms: D000208:Acute Disease; D016477:Artifacts; D016009:Chi-Square Distribution; D002986:Clinical Trials as Topic; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006801:Humans; D016015:Logistic Models; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D015337:Multicenter Studies as Topic; D015999:Multivariate Analysis; D015588:Observer Variation; D016017:Odds Ratio; D009942:Organometallic Compounds / Q000008:administration & dosage; D011237:Predictive Value of Tests; D011651:Pulmonary Artery / Q000473:pathology*; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000473:pathology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014481:United States
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine; D019786:Gadolinium DTPA