The evaluation of findings thorax diffusion magnetic resonance imaging diagnosis of patients diagnosed with pulmonary embolism with computed tomography in the emergency service

SUMMARYBackground and Aim: Pulmonary embolism (PE) is a disease that physicians frequentlyencounter in emergency room. Early diagnosis is as important as treatment. Thoraxcomputerized tomography (CT) is the most commonly used for diagnostic purpose in PE.In pregnants, patients with contrast allergy or kidney failure, thorax CT is contraindicated.Magnetic resonance imaging (MRI) is an important imaging technique because it does notcontain radiation and it has been more widely used in the last years. To investigate theusability of thorax diffusion MRI in patients with kidney failure, contrast agent allergy,pregnancy and instable patients that fast imaging is needed who are considered as PE.Material and Methods: The prospective study comprised 29 patients that admitted tohospital emergency service and were diagnosed as PE with dynamic contrast-enhanced CTbetween 5 December 2010 and 31 November 2011. Afterwards, these patients were imagedby thorax diffusion MRI.Results: In 29 patients diagnosed as PE, dispnea and chest pain were the most commonsymptoms. Mean apparent diffusion coefficient (ADC) value for all patients was 2.39x10-3±4.5 mm2/sc. Mean ADC value for infarcts was 1.98x10-3±3.3 mm2/sc. Mean ADC valuefor regions of atelectasia was 1.98x10-3±3.3 mm2/sc. Atelectasia and infarct was observedin 20 (59.1%) patients and 9 (30.9%) patients, respectively. Difference in ADC value wasstatistically significant between atelectasia and infarct (p=0.0001).Conclusion: We conclude that diffusion MRI could be an alternative method of diagnosticexamination for PE. Especially, in patients with kidney failure, contrast agent allergy,pregnancy and the situations in which fast imaging is needed, thorax diffusion-weightedimaging could provide very useful results in the diagnosis of PE. More detailed studiesconducted in earlier period with larger patients are needed to use thorax diffusion MRI as atool in the diagnosis of PE.Key Words: Pulmonary embolism, thorax diffusion magnetic resonance image, thoraxcomputerized tomography.