Prospective comparison of MR lung perfusion and lung scintigraphy

This study attempted to assess the accuracy and potential of lung magnetic resonance (MR) perfusion imaging compared with perfusion scintigraphy in th e evaluation of patients with suspected lung perfusion defects. The techniq ue, which uses an Inversion recovery tube-FLASH sequence with ultra-short T E (1.4 msec), was tested in 24 patients suspected clinically of having acut e pulmonary embolism (n = 19) and in patients with severe pulmonary emphyse ma (n = 5), Perfusion lung scintigraphy was performed within 48 hours prior to the MRI examination in both groups of patients. The dynamic study was a cquired in the coronal plane and consisted of 10 images of 6 slices (a tota l of 60 images per series), Gadopentetate dimeglumine (0.1 mmol/kg) was man ually injected as a compact bolus during the acquisition of the first image . Three senior radiologists reviewed all unprocessed two-dimensional corona l sections. They were blinded to clinical data and other imaging modalities , For the three observers, the average sensitivity and specificity of MR we re 69% and 91%, respectively. The overall agreement between MR and scintigr aphy appears to be good, with a good correlation between the two modalities (kappa = 0.63), However, the data showed variability depending on the loca tion of the perfusion defect, with higher accuracy in the upper lobes, The agreement between MR perfusion and scintigraphy appears to be moderate in t he left inferior lobe (kappa = 0.48), The data showed an overall good inter obsever agreement (kappa = 0.66), MR perfusion of the lung is a promising t echnique in detecting lung perfusion defects. J, Magn. Reson, Imaging 1999; 9:61-68, (C) 1999 Wiley-Liss, Inc.