64-Multidetector-row spiral CT in pulmonary embolism with emphasis on incidental findings

Autor: Markus Heuser, Erick Amarteifio, Christian Sohns, Silvia Obenauer, Samuel Sossalla
Rok vydání: 2008
Předmět:
Adult
Male
medicine.medical_specialty
Contrast Media
030204 cardiovascular system & hematology
Thigh
Risk Assessment
Sensitivity and Specificity
Severity of Illness Index
030218 nuclear medicine & medical imaging
Cohort Studies
Young Adult
03 medical and health sciences
Age Distribution
0302 clinical medicine
medicine
Humans
Radiology
Nuclear Medicine and imaging
Sex Distribution
Thrombus
Aged
Retrospective Studies
Aged
80 and over
Venous Thrombosis
Incidental Findings
Vascular disease
business.industry
Incidence
Respiratory disease
Retrospective cohort study
Middle Aged
medicine.disease
Thrombosis
3. Good health
Pulmonary embolism
Venous thrombosis
medicine.anatomical_structure
Acute Disease
Radiographic Image Interpretation
Computer-Assisted
Female
Radiology
Pulmonary Embolism
business
Tomography
Spiral Computed
Zdroj: Clinical Imaging. 32:335-341
ISSN: 0899-7071
DOI: 10.1016/j.clinimag.2008.01.028
Popis: 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.
Databáze: OpenAIRE
Externí odkaz: