Acute pulmonary embolism in the era of multi-detector CT: a reality in sub-Saharan Africa

Abstract

BackgroundThe advantages of multi-detector computed tomography (MDCT) have made it the imaging modality of choice for some patients with suspected cardiothoracic disease, of which pulmonary embolism (PE) is an exponent. The aim of this study was to assess the incidence of PE in patients with clinical suspicion of acute PE using MDCT in a sub-Saharan setting, and to describe the demographic characteristics of these patients.MethodsConsecutive records of patients who underwent MDCT pulmonary angiography for suspected acute PE over a two-year period at the Radiology Department of a university-affiliated hospital were systematically reviewed. All MDCT pulmonary angiograms were performed with a 16-detector computed tomography (CT) scanner using real-time bolus tracking technique. Authorization for the study was obtained from the institutional authorities.ResultsForty-one MDCT pulmonary angiograms were reviewed of which 37 were retained. Of the 4 excluded studies, 3 were repeat angiograms and 1 study was not technically adequate. Twelve of 37 patients (32.4%) had CT angiograms that were positive for PE, of which 7 were males. The mean age of these patients was 47.6±10.5 years (age range from 33 to 65 years). Twenty five patients out of 37 (67.6%) had CT angiograms that were negative for PE. Eleven PE-positive patients (91.7%) had at least 1 identifiable thromboembolic risk factor whilst 5 PE-negative patients (20%) also had at least a thromboembolic risk factor. The relative risk of the occurrence of PE in patients with at least a thromboembolic risk factor was estimated at 14.4.ConclusionAcute PE is a reality in sub-Saharan Africa, with an increased likelihood of MDCT evidence in patients with clinical suspicion of PE who have at least a thromboembolic risk factor. The increasing availability of MDCT will help provide more information on the occurrence of PE in these settings.

Clinical and Demographic Predictors of Acute Pulmonary Embolism in Central Africa Using 64-Rows Multi-Detector Computed Tomography Angiography

“…In this work, no association was observed between the gender and the presence of PE. This result which disagrees reports from some western countries (Di Minno et al, 2016;Panigada et al, 2016), is consistent with other Africans series (Ongeng'o et al, 2011;Tambe et al, 2012). We believe that the discrepancy of results between African and western series may be due to the relative lack of wide used of oral contraceptive in African female.…”

“…The number of cases may be very high in our region, but the low socioeconomic status of the general population (with no access to adequate health care with out of hospital death of subjects) and the number CT machines may limits how serious the disease may be as recently found by others authors (Tambe et al, 2012).…”

“…In recent years elsewhere in Africa, studies concerning detection of PE by MDCTA have been conducted and they found that PE is not uncommon (Owusu, 2009;Ongeng'o et al, 2011;Tambe et al, 2012). PE is a preventable disease and it is necessary to be aware of factors associated with this cause of sudden death.…”

The prevalence and radiological findings of pulmonary embolism in HIV-positive patients referred for computed tomography pulmonary angiography in the Western Cape of South Africa

“…A study in Cameroon (Africa), undertaken at a university-affiliated hospital, demonstrated a CTPA incidence of PE of 32.4% over a two-year period. 6 Our CTPA prevalence of PE is comparable at 26%.…”

“… 5 A study undertaken at a universityaffiliated hospital in Cameroon reported a 32.4% incidence of PE in patients with clinical suspicion of PE, using computed tomography pulmonary angiography (CTPA). 6 …”