PURPOSE: To compare multi-detector row computed tomography (CT) and ventilation-perfusion (V-P) scintigraphy in the diagnosis of acute pulmonary embolism (PE) in outpatients who were cared for in the emergency department. MATERIALS AND METHODS: Ninety-four nonconsecutive patients, in whom acute PE was suspected, underwent thin-collimation multi-detector row CT (collimation, 4 x 1 mm; pitch, 1.25; scanning time, 0.5 second) and V-P scintigraphy. Concordance between CT and scintigraphic images was used in the diagnosis of PE. Pulmonary angiography was performed within 24 hours if interpretations of V-P and spiral CT images were inconclusive or discordant. Sensitivity and specificity values were calculated for V-P scintigrams and CT scans of the lungs. The rates of conclusive results for scintigraphy and CT were compared. RESULTS: The sensitivity of thin-collimation multi-detector row CT and V-P scintigraphy for the detection of PE was 96% (27 of 28; CI: 82%, 99%) and 98% (65 of 66; CI: 92%, 99%), respectively. The specificity of CT and V-P scintigraphy was 86% (24 of 28; CI: 67%, 96%) and 88% (58 of 66; CI: 77%, 94%), respectively. Seven V-P scintigrams were of intermediate probability, and one spiral CT study was indeterminate. Examinations with spiral CT yielded conclusive results more often than examinations with planar V-P scintigraphy (P <.05). Five V-P scintigrams and spiral CT scans were discordant. Twelve pulmonary angiographic examinations were performed. Angiographic findings were concordant in 10 (91%) of 11 patients with conclusive CT scans in whom pulmonary angiography was attempted. CT was used to establish an alternative diagnosis in 19 (29%) of 66 patients in whom PE was excluded. CONCLUSION: Thin-collimation multi-detector row CT is more accurate than V-P scintigraphy in the diagnosis of acute PE in outpatients. Furthermore, CT provides alternative diagnoses for patients without PE on high-quality transverse or near-isotropic reformatted images.
PURPOSE: To compare multi-detector row computed tomography (CT) and ventilation-perfusion (V-P) scintigraphy in the diagnosis of acute pulmonary embolism (PE) in outpatients who were cared for in the emergency department. MATERIALS AND METHODS: Ninety-four nonconsecutive patients, in whom acute PE was suspected, underwent thin-collimation multi-detector row CT (collimation, 4 x 1 mm; pitch, 1.25; scanning time, 0.5 second) and V-P scintigraphy. Concordance between CT and scintigraphic images was used in the diagnosis of PE. Pulmonary angiography was performed within 24 hours if interpretations of V-P and spiral CT images were inconclusive or discordant. Sensitivity and specificity values were calculated for V-P scintigrams and CT scans of the lungs. The rates of conclusive results for scintigraphy and CT were compared. RESULTS: The sensitivity of thin-collimation multi-detector row CT and V-P scintigraphy for the detection of PE was 96% (27 of 28; CI: 82%, 99%) and 98% (65 of 66; CI: 92%, 99%), respectively. The specificity of CT and V-P scintigraphy was 86% (24 of 28; CI: 67%, 96%) and 88% (58 of 66; CI: 77%, 94%), respectively. Seven V-P scintigrams were of intermediate probability, and one spiral CT study was indeterminate. Examinations with spiral CT yielded conclusive results more often than examinations with planar V-P scintigraphy (P <.05). Five V-P scintigrams and spiral CT scans were discordant. Twelve pulmonary angiographic examinations were performed. Angiographic findings were concordant in 10 (91%) of 11 patients with conclusive CT scans in whom pulmonary angiography was attempted. CT was used to establish an alternative diagnosis in 19 (29%) of 66 patients in whom PE was excluded. CONCLUSION: Thin-collimation multi-detector row CT is more accurate than V-P scintigraphy in the diagnosis of acute PE in outpatients. Furthermore, CT provides alternative diagnoses for patients without PE on high-quality transverse or near-isotropic reformatted images.
Authors: Jared Martillotti; Naomi Silva; Jyoti Chhabra; Christian Molstrom; Ryan Coughlin; Michael O'Loughlin; Bret Coughlin Journal: Emerg Radiol Date: 2012-08-17
Authors: Tobias De Zordo; Klemens von Lutterotti; Christian Dejaco; Peter F Soegner; Renate Frank; Friedrich Aigner; Andrea S Klauser; Christoph Pechlaner; U Joseph Schoepf; Werner R Jaschke; Gudrun M Feuchtner Journal: Eur Radiol Date: 2011-08-28 Impact factor: 5.315
Authors: Sara A Hayes; Gerald A Soff; Emily C Zabor; Chaya S Moskowitz; Corinne C Liu; Michelle S Ginsberg Journal: Clin Imaging Date: 2014-05-06 Impact factor: 1.605