Performance of perfusion-weighted Fourier decomposition MRI for detection of chronic pulmonary emboli

Christian Schönfeld, Serghei Cebotari, Andreas Voskrebenzev, Marcel Gutberlet, Jan Hinrichs, Julius Renne, Marius M. Hoeper, Karen M. Olsson, Tobias Welte, Frank Wacker, Jens Vogel-Claussen

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Abstract

Purpose To evaluate the test performance of perfusion-weighted Fourier-decomposition (pw-FD) magnetic resonance imaging (MRI) in comparison to dynamic contrast-enhanced (DCE)-MRI as a reference standard in patients with known or suspected chronic pulmonary embolism (PE). Materials and Methods In 64 patients, chronic PE was ruled out or confirmed by DCE-MRI using a time-resolved angiography with stochastic trajectories (TWIST) sequence in one breath-hold. Pw-FD-MRI was performed using a 2D fast low-angle shot (FLASH) sequence in free-breathing. After a nonrigid image registration, FD was applied to generate pw-images. Lungs were scored by two radiologists (2 and 12 years of lung MRI experience) visually for each lobe and segment for hypoperfused areas. For intra- and interobserver variability, the MR images were analyzed 2 months after the first analysis, blinded to the results of the first reader. Results PE was diagnosed by DCE-MRI in 39 patients. For the pw-FD MRI sensitivity, specificity, accuracy, and positive and negative predictive value for diagnosis of PE were 100%, 95%, 98%, 98%, and 100% on a per-patient basis, 94%, 94%, 94%, 95%, 94% on a per-lobe basis, and 82%, 92%, 88%, 88%, 88% on a segmental basis, respectively. Detection of subsegmental and segmental hypoperfusion using pw-FD MRI showed a moderate agreement with DCE-MRI (kappa of 0.68; 95% confidence interval: 0.64; 0.72). Conclusion Pw-FD of the lung is a feasible test to diagnose chronic PE on a per-patient level during free-breathing without the use of ionizing radiation or contrast agents.

Original languageEnglish (US)
Pages (from-to)72-79
Number of pages8
JournalJournal of Magnetic Resonance Imaging
Volume42
Issue number1
DOIs
StatePublished - Jul 1 2015

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Keywords

  • Fourier decomposition
  • dynamic contrast enhanced MRI
  • lung perfusion
  • pulmonary embolism

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Schönfeld, C., Cebotari, S., Voskrebenzev, A., Gutberlet, M., Hinrichs, J., Renne, J., Hoeper, M. M., Olsson, K. M., Welte, T., Wacker, F., & Vogel-Claussen, J. (2015). Performance of perfusion-weighted Fourier decomposition MRI for detection of chronic pulmonary emboli. Journal of Magnetic Resonance Imaging, 42(1), 72-79. https://doi.org/10.1002/jmri.24764