OBJECTIVE: This study was designed to prospectively compare helical CT with pulmonary angiography in the detection of pulmonary embolism in patients with an unresolved clinical and scintigraphic diagnosis. SUBJECTS AND METHODS: Twenty patients with an unresolved suspicion of pulmonary embolism were evaluated with contrast-enhanced helical CT and with selective pulmonary angiography. An average of 11 hr separated the two studies. The CT scans were obtained during one 24-sec or two 12-sec breath-holds. CT scans were interpreted without knowledge of the results of scintigraphy or angiography. Selective pulmonary angiograms were obtained with knowledge of the findings on the ventilation/perfusion scan only. The sensitivity and specificity of CT were compared with those of angiography for central vessels (segmental and larger) only and for all vessels. RESULTS: Eleven of the 20 patients had proved pulmonary embolism (seven in central vessels and four in subsegmental vessels only). When only central vessels were analyzed, CT sensitivity was 86%, specificity was 92%, and the likelihood ratio was 10.7. However, when subsegmental vessels were included, CT results were 63%, 89%, and 5.7, respectively. CONCLUSION: In our subset of patients, helical CT was only 63% sensitive. Subsegmental emboli are difficult to diagnose. Pulmonary angiography remains the study of choice. CT has a limited role in the evaluation of acute pulmonary embolism.
OBJECTIVE: This study was designed to prospectively compare helical CT with pulmonary angiography in the detection of pulmonary embolism in patients with an unresolved clinical and scintigraphic diagnosis. SUBJECTS AND METHODS: Twenty patients with an unresolved suspicion of pulmonary embolism were evaluated with contrast-enhanced helical CT and with selective pulmonary angiography. An average of 11 hr separated the two studies. The CT scans were obtained during one 24-sec or two 12-sec breath-holds. CT scans were interpreted without knowledge of the results of scintigraphy or angiography. Selective pulmonary angiograms were obtained with knowledge of the findings on the ventilation/perfusion scan only. The sensitivity and specificity of CT were compared with those of angiography for central vessels (segmental and larger) only and for all vessels. RESULTS: Eleven of the 20 patients had proved pulmonary embolism (seven in central vessels and four in subsegmental vessels only). When only central vessels were analyzed, CT sensitivity was 86%, specificity was 92%, and the likelihood ratio was 10.7. However, when subsegmental vessels were included, CT results were 63%, 89%, and 5.7, respectively. CONCLUSION: In our subset of patients, helical CT was only 63% sensitive. Subsegmental emboli are difficult to diagnose. Pulmonary angiography remains the study of choice. CT has a limited role in the evaluation of acute pulmonary embolism.
Authors: Marco J L van Strijen; Wouter de Monyé; Gerard J Kieft; Peter M T Pattynama; Menno V Huisman; Sierd J Smith; Johan L Bloem Journal: Eur Radiol Date: 2002-11-19 Impact factor: 5.315
Authors: Frank Oliver G Henes; Michael Groth; Marc Regier; Thorsten Bley; Hans-Dieter Nagel; Gerhard Adam; Philipp G C Begemann Journal: Emerg Radiol Date: 2010-07-04
Authors: U Joseph Schoepf; Christoph R Becker; Lars K Hofmann; Marco Das; Thomas Flohr; Bernd M Ohnesorge; Bernhard Baumert; Joshua Rolnick; Jean M Allen; Vassilios Raptopoulos Journal: Eur Radiol Date: 2003-02-26 Impact factor: 5.315
Authors: D Collomb; P J Paramelle; O Calaque; J L Bosson; G Vanzetto; D Barnoud; C Pison; M Coulomb; G Ferretti Journal: Eur Radiol Date: 2003-02-07 Impact factor: 5.315