In 1 study, detection of thoracic aorta pathology by contrast-enhanced chest MRA was equivalent in sensitivity, specificity, and diagnostic accuracy compared to noncontrast MRA, although only a single case of thrombus was included in the analysis [43]. On the other hand, in a small analysis which included 9 patients with aortic thrombus, contrast-enhanced MRA had a lower thrombus detection rate compared to a noncontrast examination, although this finding was not statistically significant [44]. Data comparing MRA of the chest to other imaging modalities are lacking. MRA Chest Without IV Contrast In some conditions or clinical scenarios, there may be a high suspicion that the embolic source is in the thoracic aorta and an MRA limited to the chest may be diagnostic. One small study found this examination to have a higher detection rate for aortic thrombus when compared with contrast-enhanced MRA, although the difference was not statistically significant [44]. In another study, sensitivity, specificity, and diagnostic accuracy of unenhanced steady- state free precession MRA were 100% for the detection of thoracic aorta pathology compared to a contrast-enhanced MRA reference standard; however, this analysis only included 1 case of mural thrombus [43]. Data comparing MRA of the chest to other imaging modalities is lacking. MRA Chest, Abdomen, and Pelvis Without and With IV Contrast MRA of the chest, abdomen, and pelvis without and with IV contrast can be used to evaluate for the presence of an embolic source in the aorta in its entirety. In 1 study, detection of thoracic aorta pathology by contrast-enhanced chest MRA was equivalent in sensitivity, specificity, and diagnostic accuracy compared to noncontrast MRA, although only a single case of thrombus was included in the analysis [43].
Workup of Noncerebral Systemic Arterial Embolic Source. In 1 study, detection of thoracic aorta pathology by contrast-enhanced chest MRA was equivalent in sensitivity, specificity, and diagnostic accuracy compared to noncontrast MRA, although only a single case of thrombus was included in the analysis [43]. On the other hand, in a small analysis which included 9 patients with aortic thrombus, contrast-enhanced MRA had a lower thrombus detection rate compared to a noncontrast examination, although this finding was not statistically significant [44]. Data comparing MRA of the chest to other imaging modalities are lacking. MRA Chest Without IV Contrast In some conditions or clinical scenarios, there may be a high suspicion that the embolic source is in the thoracic aorta and an MRA limited to the chest may be diagnostic. One small study found this examination to have a higher detection rate for aortic thrombus when compared with contrast-enhanced MRA, although the difference was not statistically significant [44]. In another study, sensitivity, specificity, and diagnostic accuracy of unenhanced steady- state free precession MRA were 100% for the detection of thoracic aorta pathology compared to a contrast-enhanced MRA reference standard; however, this analysis only included 1 case of mural thrombus [43]. Data comparing MRA of the chest to other imaging modalities is lacking. MRA Chest, Abdomen, and Pelvis Without and With IV Contrast MRA of the chest, abdomen, and pelvis without and with IV contrast can be used to evaluate for the presence of an embolic source in the aorta in its entirety. In 1 study, detection of thoracic aorta pathology by contrast-enhanced chest MRA was equivalent in sensitivity, specificity, and diagnostic accuracy compared to noncontrast MRA, although only a single case of thrombus was included in the analysis [43].