A number of small studies have used CTA to detect aortic mural thrombus that was suspected of embolization [1,12-14,42]. Specific data on the sensitivity and specificity of this imaging modality are lacking. MRA Chest Without and With 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. 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 6 Workup of Noncerebral Systemic Arterial Embolic Source 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.
Workup of Noncerebral Systemic Arterial Embolic Source. A number of small studies have used CTA to detect aortic mural thrombus that was suspected of embolization [1,12-14,42]. Specific data on the sensitivity and specificity of this imaging modality are lacking. MRA Chest Without and With 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. 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 6 Workup of Noncerebral Systemic Arterial Embolic Source 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.