AIM: In this retrospective study, we assess the current role and future potential of computed tomography (CT) in the diagnostic algorithm of acute pulmonary embolism (PE). MATERIALS AND METHODS: Two hundred patients underwent 64-multidetector-row spiral CT of the chest, pelvis, and thigh for suspected PE. CT scans were reviewed, and the degree of contrast enhancement and the presence of PE and/or (deep) venous thrombosis were recorded. In the case of PE, the level of thrombus was noted as central, main, or lobar. If the scan yielded a positive result for thrombosis, intravenous localization was also determined. Patient age, length of admission, clinical course, clinical indication, and incidental findings were registered as well. RESULTS: PE was detected in 60 of the 200 patients with a high clinical probability of having PE (30%). Thirty-four patients had a positive CT scan result for venous thrombosis (17%). Twenty-four of the 60 patients had proximal deep venous thrombosis (40%), and 2 patients had arm venous thrombosis (3%). Thirty-four of the 60 patients had PE without venous thrombosis (57%). Eight of the 200 patients had deep venous thrombosis without suspicion of PE (4%). The distribution of the proximal thrombi showed 15 in a central artery (25%), 13 in a main pulmonary artery (22%), and 32 in a lobar segmental artery (53%). There was diffuse allocation of the thrombus in all lobes. Furthermore, CT scan noted a total of 120 incidental findings. CONCLUSION: Our study indicates the potential clinical use of a diagnostic strategy for ruling out PE based on D-dimer testing and multidetector-row CT. A larger outcome study is needed before this approach can be adopted.
AIM: In this retrospective study, we assess the current role and future potential of computed tomography (CT) in the diagnostic algorithm of acute pulmonary embolism (PE). MATERIALS AND METHODS: Two hundred patients underwent 64-multidetector-row spiral CT of the chest, pelvis, and thigh for suspected PE. CT scans were reviewed, and the degree of contrast enhancement and the presence of PE and/or (deep) venous thrombosis were recorded. In the case of PE, the level of thrombus was noted as central, main, or lobar. If the scan yielded a positive result for thrombosis, intravenous localization was also determined. Patient age, length of admission, clinical course, clinical indication, and incidental findings were registered as well. RESULTS: PE was detected in 60 of the 200 patients with a high clinical probability of having PE (30%). Thirty-four patients had a positive CT scan result for venous thrombosis (17%). Twenty-four of the 60 patients had proximal deep venous thrombosis (40%), and 2 patients had arm venous thrombosis (3%). Thirty-four of the 60 patients had PE without venous thrombosis (57%). Eight of the 200 patients had deep venous thrombosis without suspicion of PE (4%). The distribution of the proximal thrombi showed 15 in a central artery (25%), 13 in a main pulmonary artery (22%), and 32 in a lobar segmental artery (53%). There was diffuse allocation of the thrombus in all lobes. Furthermore, CT scan noted a total of 120 incidental findings. CONCLUSION: Our study indicates the potential clinical use of a diagnostic strategy for ruling out PE based on D-dimer testing and multidetector-row CT. A larger outcome study is needed before this approach can be adopted.
Authors: Christian Sohns; Dirk Vollmann; Lars Luethje; Marc Dorenkamp; Joachim Seegers; Jan D Schmitto; Markus Zabel; Silvia Obenauer Journal: World J Radiol Date: 2011-02-28
Authors: Mark L Schiebler; Jitesh Ahuja; Michael D Repplinger; Christopher J François; Karl K Vigen; Thomas M Grist; Azita G Hamedani; Scott B Reeder; Scott K Nagle Journal: Eur J Radiol Date: 2016-05-19 Impact factor: 3.528