Multiparametric MRI in differentiating pulmonary artery sarcoma and pulmonary thromboembolism: a preliminary experience

LİU, Min; Wang, Ying; ZHANG, Tianjing; LUO, Chunhai; GUO, Xiaojuan; MA, Zhanhong; YANG, Yuanhua

Multiparametric MRI in differentiating pulmonary artery sarcoma and pulmonary thromboembolism: a preliminary experience

Min LİU, (From the Departments of Radiology)

Chunhai LUO, (Beijing Chaoyang Hospital of Capital Medical University, Beijing, China; Department of Radiology)

Ying WANG, (Clinical Pathology)

Xiaojuan GUO, (From the Departments of Radiology)

Zhanhong MA, (From the Departments of Radiology)

Yuanhua YANG, (Respiratory Diseases Research Center)

Tianjing ZHANG (the second affiliated Hospital of Xi'an Medical College, Xi'an City, China; Siemens MR Northeastern Collaboration Application Department)

Diagnostic and Interventional Radiology

6 1

Yıl: 2017 Cilt: 23 Sayı: 1 Sayfa Aralığı: 15 - 21 Metin Dili: İngilizce İndeks Tarihi: 29-07-2022

Multiparametric MRI in differentiating pulmonary artery sarcoma and pulmonary thromboembolism: a preliminary experience

Öz:

PURPOSEWe aimed to define multiparametric magnetic resonance imaging (MRI) findings to differentiatebetween pulmonary artery sarcoma (PAS) and pulmonary thromboembolism (PTE).METHODSEleven patients with suspected PTE were prospectively included to undergo pulmonary MRIbefore surgery or biopsy. MRI protocol included an unenhanced sequence, diffusion-weightedimaging (DWI, b=800 s/mm2) and a dynamic contrast-enhanced sequence. Morphologic characteristicsincluding distribution, filling defect, and intensity were observed on T1-, T2-, andfat-suppressed T2-weighted imaging, DWI, and contrast-enhanced MRI. Apparent diffusion coefficient(ADC) values were calculated.RESULTSSix patients were pathologically diagnosed as PAS and the other five as chronic PTE. There wereno significant differences in age, gender, presenting symptoms, D-dimer, and N-terminal probrainnatriuretic peptide between the two groups (P > 0.05). Among MRI findings that weretested for their ability to diagnose PAS, area under the curve (AUC) was significantly higherthan 0.5 for main pulmonary artery involvement (AUC, 0.83±0.13; P = 0.011), hyperintensity onfat-suppressed T2-weighted imaging (AUC, 0.82±0.14; P = 0.025), hyperintensity on DWI (AUC,0.88±0.12; P = 0.002), contrast enhancement (AUC, 0.92±0.10; P < 0.001) and pleural effusion(AUC, 0.82±0.14; P = 0.025). Moreover, grape-like appearance in distal pulmonary artery andcardiac invasion had 100% specificity for diagnosis of PAS. However, ADC value of PAS was notsignificantly different than that of chronic PTE (U, 12.00; P = 0.584).CONCLUSIONHyperintense filling defect in main pulmonary artery on fat-suppressed T2-weighted imagingand DWI and contrast enhancement may help to discriminate PAS from PTE.

Anahtar Kelime:

Konular: Radyoloji, Nükleer Tıp, Tıbbi Görüntüleme

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Bendel EC, Maleszewski JJ, Araoz PA. Imaging sarcomas of the great vessels and heart. Semin Ultrasound CT MR 2011; 32:377-404. [CrossRef]
2. Tueller C, Fischer Biner R, Minder S, et al. FDG-PET in diagnostic work-up of pulmonary artery sarcomas. Eur Respir J 2010; 35:444-446. [CrossRef]
3. Benz MR, Tchekmedyian N, Eilber FC, et al. Utilization of positron emission tomography in the management of patients with sarcoma. Curr Opin Oncol 2009; 21:345-351. [CrossRef]
4. Blackmon SH, Rice DC, Correa AM, et al. Management of primary pulmonary artery sarcomas. Ann Thorac Surg 2009; 87:977-984. [CrossRef]
5. Krüger I, Borowski A, Horst M, et al. Symptoms, diagnosis, and therapy of primary sarcomas of the pulmonary artery. Thorac Cardiovasc Surg 1990; 38:91-95. [CrossRef]
6. Wang Y, Rossman PJ, Grimm RC, Riederer SJ, Ehman RL. Navigator-echo-based real time and triggering for reduction of respiration effects in three dimensional coronary MR angiography. Radiology 1996; 198:55-60. [CrossRef]
7. Yi CA, Lee KS, Choe YH, Han D, Kwon OJ, Kim S. Computed tomography in pulmonary artery sarcoma distinguishing features from pulmonary embolic disease. J Comput Assist Tomogr 2004; 28:34-39. [CrossRef]
8. Cox JE, Chiles C, Aquino SL, Savage P, Oaks T. Pulmonary artery sarcomas: A review of clinical and radiologic features. J Comput Assist Tomogr 1997; 21:750-755. [CrossRef]
9. Smith WS, Lesar MS, Travis WD, Lubbers P, et al. MR and CT findings in pulmonary artery sarcoma. J Comput Assist Tomogr 1989; 13:906-909. [CrossRef]
10. Wittram C, Maher MM, Yoo AJ, Kalra MK, Shepard JA, McLoud TC. CT angiography of pulmonary embolism: diagnostic criteria and causes of misdiagnosis. Radiographics 2004; 24:1219-1238. [CrossRef]
11. Chow B, Wittram C, Lee VW. Unilateral absence of pulmonary perfusion mimicking pulmonary embolism. AJR Am J Roentgenol 2001; 176:712. [CrossRef]
12. Gan HL, Zhang JQ, Huang XY, Yu W. The wall eclipsing sign on pulmonary artery computed tomography angiography is pathognomonic for pulmonary artery sarcoma. PLoS One 2013; 8:e83200. [CrossRef]
13. Sandrasegaran K, Tahir B, Nutakki K, et al. Usefulness of conventional MRI sequences and diffusion-weighted imaging in differentiating malignant from benign portal vein thrombus in cirrhotic patients. AJR Am J Roentgenol 2013; 201:1211-1219. [CrossRef]
14. Bogaert J, Dymarkowski S. Cardiac Masses. In: Bogaert J, Dymarkowski S, Taylor AM, Muthurangu V, eds. Clinical cardiac MRI. 2nd ed. Berlin:Springer-Verlag, 2012; 411-464. [CrossRef
]15. Vidmar J, Kralj E, Bajd F, Sersa I. Multiparametric MRI in characterizing venous thrombi and pulmonary thromboemboli acquired from patients with pulmonary embolism. J Magn Reson Imaging 2015; 42:354-361. [CrossRef]
16. Koh DM, Collins DJ . Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol 2007; 188:1622-1635. [CrossRef]
17. Catalano OA, Choy G, Zhu A, Hahn PF, Sahani DV. Differentiation of malignant thrombus from bland thrombus of the portal vein in patients with hepatocellular carcinoma: application of diffusion-weighted MR imaging. Radiology 2010; 254:154-162. [CrossRef]
18. Tublin ME, Dodd GD 3rd, Baron RL. Benign and malignant portal vein thrombosis: differentiation by CT characteristics. AJR Am J Roentgenol 1997; 168:719-723. [CrossRef]
19. Okumura A, Watanabe Y, Dohke M, et al. Contrast-enhanced three-dimensional MR portography. Radiographics 1999; 19:973-987. [CrossRef]
20. Wittram C, Maher MM, Halpern E, et al. The Hounsfield unit values of acute and chronic pulmonary emboli (abstr). In: Radiological Society of North America scientific assembly and annual meeting program. Oak Brook, Ill: Radiological Society of North America, 2003; 678.

APA	LİU M, LUO C, Wang Y, GUO X, MA Z, YANG Y, ZHANG T (2017). Multiparametric MRI in differentiating pulmonary artery sarcoma and pulmonary thromboembolism: a preliminary experience. , 15 - 21.
Chicago	LİU Min,LUO Chunhai,Wang Ying,GUO Xiaojuan,MA Zhanhong,YANG Yuanhua,ZHANG Tianjing Multiparametric MRI in differentiating pulmonary artery sarcoma and pulmonary thromboembolism: a preliminary experience. (2017): 15 - 21.
MLA	LİU Min,LUO Chunhai,Wang Ying,GUO Xiaojuan,MA Zhanhong,YANG Yuanhua,ZHANG Tianjing Multiparametric MRI in differentiating pulmonary artery sarcoma and pulmonary thromboembolism: a preliminary experience. , 2017, ss.15 - 21.
AMA	LİU M,LUO C,Wang Y,GUO X,MA Z,YANG Y,ZHANG T Multiparametric MRI in differentiating pulmonary artery sarcoma and pulmonary thromboembolism: a preliminary experience. . 2017; 15 - 21.
Vancouver	LİU M,LUO C,Wang Y,GUO X,MA Z,YANG Y,ZHANG T Multiparametric MRI in differentiating pulmonary artery sarcoma and pulmonary thromboembolism: a preliminary experience. . 2017; 15 - 21.
IEEE	LİU M,LUO C,Wang Y,GUO X,MA Z,YANG Y,ZHANG T "Multiparametric MRI in differentiating pulmonary artery sarcoma and pulmonary thromboembolism: a preliminary experience." , ss.15 - 21, 2017.
ISNAD	LİU, Min vd. "Multiparametric MRI in differentiating pulmonary artery sarcoma and pulmonary thromboembolism: a preliminary experience". (2017), 15-21.

APA	LİU M, LUO C, Wang Y, GUO X, MA Z, YANG Y, ZHANG T (2017). Multiparametric MRI in differentiating pulmonary artery sarcoma and pulmonary thromboembolism: a preliminary experience. Diagnostic and Interventional Radiology, 23(1), 15 - 21.
Chicago	LİU Min,LUO Chunhai,Wang Ying,GUO Xiaojuan,MA Zhanhong,YANG Yuanhua,ZHANG Tianjing Multiparametric MRI in differentiating pulmonary artery sarcoma and pulmonary thromboembolism: a preliminary experience. Diagnostic and Interventional Radiology 23, no.1 (2017): 15 - 21.
MLA	LİU Min,LUO Chunhai,Wang Ying,GUO Xiaojuan,MA Zhanhong,YANG Yuanhua,ZHANG Tianjing Multiparametric MRI in differentiating pulmonary artery sarcoma and pulmonary thromboembolism: a preliminary experience. Diagnostic and Interventional Radiology, vol.23, no.1, 2017, ss.15 - 21.
AMA	LİU M,LUO C,Wang Y,GUO X,MA Z,YANG Y,ZHANG T Multiparametric MRI in differentiating pulmonary artery sarcoma and pulmonary thromboembolism: a preliminary experience. Diagnostic and Interventional Radiology. 2017; 23(1): 15 - 21.
Vancouver	LİU M,LUO C,Wang Y,GUO X,MA Z,YANG Y,ZHANG T Multiparametric MRI in differentiating pulmonary artery sarcoma and pulmonary thromboembolism: a preliminary experience. Diagnostic and Interventional Radiology. 2017; 23(1): 15 - 21.
IEEE	LİU M,LUO C,Wang Y,GUO X,MA Z,YANG Y,ZHANG T "Multiparametric MRI in differentiating pulmonary artery sarcoma and pulmonary thromboembolism: a preliminary experience." Diagnostic and Interventional Radiology, 23, ss.15 - 21, 2017.
ISNAD	LİU, Min vd. "Multiparametric MRI in differentiating pulmonary artery sarcoma and pulmonary thromboembolism: a preliminary experience". Diagnostic and Interventional Radiology 23/1 (2017), 15-21.