Perfusion abnormalities in pulmonary embolism studied with perfusion MRI and ventilation‐perfusion scintigraphy: An intra‐modality and inter‐modality agreement study
- 27 March 2002
- journal article
- research article
- Published by Wiley in Journal of Magnetic Resonance Imaging
- Vol. 15 (4), 386-394
- https://doi.org/10.1002/jmri.10092
Abstract
Purpose To compare perfusion magnetic resonance imaging (MRI) and ventilation‐perfusion scintigraphy (V‐P scan) in the study of perfusion abnormalities in pulmonary embolism (PE) and to compare the PE results to the findings previously reported for pneumonia and chronic obstructive pulmonary disease (COPD), in terms of perfusion abnormalities. Materials and Methods Dynamic contrast‐enhanced MR images and V‐P scans of 20 patients with PE, 11 patients with acute pneumonia, and 13 patients with exacerbation of COPD were studied. Five categories of perfusion abnormalities within each imaging modality were defined. Intra‐ and inter‐modality agreement (kappa values) in the evaluation of perfusion abnormalities were calculated, based on the two observers of each imaging modality (all blinded to each other and true diagnosis). Finally, three categories of perfusion MRI diagnosis (PE, pneumonia, and COPD) were also defined and the inter‐observer agreement (kappa value) was calculated. Results For PE, the intra‐modality agreement (kappa value) in the evaluation of perfusion abnormalities was 0.77 for MRI and 0.65 for V‐P scan. The inter‐modality agreement varied from 0.52 to 0.57, respectively, and was observer‐dependent. For the pooled group of PE, pneumonia, and COPD, the intra‐modality agreement of perfusion abnormalities was 0.76 for MRI and 0.65 for V‐P scan, and the inter‐modality agreement varied from 0.51 to 0.56. The kappa value for inter‐observer agreement for MRI diagnosis was 0.92. Conclusion Evaluation of perfusion abnormalities in PE, pneumonia, and COPD using perfusion MRI and V‐P scan showed a high intra‐modality agreement that was higher than the inter‐modality agreement. Further studies are now needed in patients presenting with possible PE to evaluate the sensitivity and specificity of the method. J. Magn. Reson. Imaging 2002;15:386–394.Keywords
Funding Information
- Norwegian Research Council
This publication has 14 references indexed in Scilit:
- Evaluation of regional pulmonary perfusion using ultrafast magnetic resonance imagingMagnetic Resonance in Medicine, 2001
- Perfusion magnetic resonance imaging of the lung: Characterization of pneumonia and chronic obstructive pulmonary disease. A feasibility studyJournal of Magnetic Resonance Imaging, 2000
- Combination of clinical and V/Q scan assessment for the diagnosis of pulmonary embolism: a 2-year outcome prospective study.European Journal of Nuclear Medicine and Molecular Imaging, 2000
- NOVEL TECHNIQUES FOR MR IMAGING OF PULMONARY AIRSPACESMagnetic Resonance Imaging Clinics of North America, 2000
- Diagnosis of Pulmonary Embolism with Magnetic Resonance AngiographyNew England Journal of Medicine, 1997
- Pulmonary embolism: detection with MR perfusion imaging of lung--a feasibility study.Radiology, 1997
- Pulmonary perfusion: Qualitative assessment with dynamic contrast‐enhanced MRI using ultra‐short TE and inversion recovery turbo FLASHMagnetic Resonance in Medicine, 1996
- Invasive and Noninvasive Diagnosis of Pulmonary EmbolismChest, 1995
- Value of the Ventilation/Perfusion Scan in Acute Pulmonary EmbolismJAMA, 1990