Ju Hee Yeo1, Lifeng Zhou2, Remy Lim1. 1. Department of Radiology, North Shore Hospital, Waitemata DHB, Auckland, New Zealand. 2. Planning and Funding, Waitemata DHB, Auckland, New Zealand.
Abstract
INTRODUCTION: This study assessed the rate of indeterminate CT pulmonary angiogram (CTPA) in a general hospital and evaluated potential contributing factors to an indeterminate CTPA and patients' eventual clinical outcome. METHODS: Four hundred and three consecutive CTPA and their finalised report from 01/08/2012 to 05/12/2012 at Waitemata DHB were reviewed retrospectively. Patient demographics, scan parameters and average Hounsfield unit (HU) of the main pulmonary trunk (PT) and likely cause of indeterminate study were documented. Studies were categorised into diagnostic, suboptimal or non-diagnostic studies. Univariate and multiple regression analyses were employed. RESULTS: Six per cent (n = 24) of the studies were deemed indeterminate which included suboptimal and non-diagnostic studies. Seven pregnant patients were scanned during the study period and four of the seven studies were deemed indeterminate. In univariate analysis, predictors of indeterminate studies included 'weight' (P = 0.022), 'average HU of PT' (P < 0.0001) and 'effective dose' (P = 0.0003). In the multivariate logistic regression model, only 'average HU of PT' was associated with indeterminate studies (OR = 0.99, 95%CI: 0.99, 1.00). Twelve of 24 indeterminate studies had suboptimal pulmonary enhancement with causes including suboptimal timing of contrast bolus, hyperdynamic state due to pregnancy and transient interruption of contrast. Three patients had excessive noise due to body habitus. Eight studies had motion artefacts and one patient had left lower lobe pneumonia which decreased the accuracy. A third of the indeterminate studies were clinically considered as negative by referring clinicians. CONCLUSIONS: Pulmonary trunk average Hounsfield unit is a predictor of indeterminate CT pulmonary angiogram.
INTRODUCTION: This study assessed the rate of indeterminate CT pulmonary angiogram (CTPA) in a general hospital and evaluated potential contributing factors to an indeterminate CTPA and patients' eventual clinical outcome. METHODS: Four hundred and three consecutive CTPA and their finalised report from 01/08/2012 to 05/12/2012 at Waitemata DHB were reviewed retrospectively. Patient demographics, scan parameters and average Hounsfield unit (HU) of the main pulmonary trunk (PT) and likely cause of indeterminate study were documented. Studies were categorised into diagnostic, suboptimal or non-diagnostic studies. Univariate and multiple regression analyses were employed. RESULTS: Six per cent (n = 24) of the studies were deemed indeterminate which included suboptimal and non-diagnostic studies. Seven pregnant patients were scanned during the study period and four of the seven studies were deemed indeterminate. In univariate analysis, predictors of indeterminate studies included 'weight' (P = 0.022), 'average HU of PT' (P < 0.0001) and 'effective dose' (P = 0.0003). In the multivariate logistic regression model, only 'average HU of PT' was associated with indeterminate studies (OR = 0.99, 95%CI: 0.99, 1.00). Twelve of 24 indeterminate studies had suboptimal pulmonary enhancement with causes including suboptimal timing of contrast bolus, hyperdynamic state due to pregnancy and transient interruption of contrast. Three patients had excessive noise due to body habitus. Eight studies had motion artefacts and one patient had left lower lobe pneumonia which decreased the accuracy. A third of the indeterminate studies were clinically considered as negative by referring clinicians. CONCLUSIONS: Pulmonary trunk average Hounsfield unit is a predictor of indeterminate CT pulmonary angiogram.
Authors: Vincent Cascio; Man Hon; Linda B Haramati; Animesh Gour; Peter Spiegler; Sanjeev Bhalla; Douglas S Katz Journal: Br J Radiol Date: 2018-06-27 Impact factor: 3.039
Authors: Cécile Tromeur; Liselotte M van der Pol; Pierre-Yves Le Roux; Yvonne Ende-Verhaar; Pierre-Yves Salaun; Christophe Leroyer; Francis Couturaud; Lucia J M Kroft; Menno V Huisman; Frederikus A Klok Journal: Haematologica Date: 2018-08-16 Impact factor: 9.941
Authors: David Sin; Gordon McLennan; Fabian Rengier; Ihab Haddadin; Gustavo A Heresi; John R Bartholomew; Matthias A Fink; Dustin Thompson; Sasan Partovi Journal: Int J Cardiovasc Imaging Date: 2020-08-30 Impact factor: 2.357