肺梗塞の診断に緊急MRAが有用であった1例

A 72-year-old woman was admitted to our hospital after developing dyspnea and chest pain. Arterial blood gas examination showed severe hypoxia. Doppler echocardiography showed a marked increase in pulmonary artery systolic pressure to 70 mmHg. Magnetic resonance angiography (MRA) indicated that there was a thrombus in the right pulmonary artery. Based on these results, the patient was diagnosed as having pulmonary artery embolism for which she received heparin and urokinase for 7 and 3 days, respectively. From the 5th day of hospitalization, she received warfarin to prevent the recurrence of pulmonary artery thrombosis. On the 40th day, repeat MRA revealed that the thrombus in the right pulmonary artery had resolved. Repeat doppler echocardiography showed that the pulmonary artery systolic pressure had decreased to 23 mmHg. MRA is useful for the noninvasive diagnosis of pulmonary artery embolism and the accurate evaluation of the efficacy of thrombolytic therapy.