Diagnostic Accuracy of Contrast-Enhanced MR Angiography & Non-Contrast Proton MR Imaging Compared with CT Pulmonary Angiography in Chronic Thromboembolic Pulmonary Hypertension

Smitha Rajaram¹, Andy James Swift¹, David Capener¹, Adam Telfer¹, Judith Hurdman², Robin Condliffe², Charlie Elliot², Christine Davies³, Catherine Hill³, David G. Kiely², Jim M. Wild¹

The aim of our study was to evaluate the diagnostic accuracy of contrast enhanced MR angiography (c-MRA) and added benefit of non-contrast proton MRI compared to CT pulmonary angiography (CTPA) in patients with chronic thromboembolic disease. Our results show that c-MRA has a very good sensitivity and specificity for diagnosing CTEPH. The sensitivity of c-MRA for visualization of adherent central and lobar thrombus significantly improves with the addition of the SSFP sequence that clearly delineates the vessel wall. CTPA is superior for depiction of intraluminal webs and sub-segmental disease, while c-MRA is superior in identifying stenosis and post-stenotic dilatations