Clinical Value of Thin Collimation in the Diagnostic Workup of Pulmonary Embolism

Rémy‐Jardin, Martine; Rémy, Jacques; F, Baghaïe; M, Fribourg; Artaud, D; Duhamel, Alain

doi:10.2214/ajr.175.2.1750407

Cited by 112 publications

(61 citation statements)

References 12 publications

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“…Such partial identification of vessels may create false-positive and false-negative results or lead the observer to an indeterminate answer [13]. Using thin-collimation and subsecond single-slice CT, Remy-Jardin et al have previously reported significant improvement in image quality due to a higher spatial resolution, resulting from a higher rate of analyzable segmental pulmonary arteries and a reduction in interpretive difficulties due to volume averaging [5,6]. Further improvement has recently been shown with multislice CT enabling an accurate analysis of peripheral pulmonary arteries down to the fifth order [8].…”

Section: Discussionmentioning

confidence: 99%

“…An important step was the availability of subsecond scanning in the late 1990s which allowed scanning of patients with thinner collimations, i.e., 3-to 2 mm, over a longer region of interest. Whereas this optimization of technical factors allowed marked improvement in the evaluation of the segmental pulmonary arterial bed, there remained limitations in the evaluation of subsegmental pulmonary arteries [5,6]. With a recent increase in gantry speed from one to two revolutions per second, multisection CT scanners are now up to eight times faster than conventional single-section spiral CT scanners, allowing greater anatomic coverage and better longitudinal resolution during a single breath hold [7].…”

Section: Introductionmentioning

confidence: 99%

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CT angiography of pulmonary embolism in patients with underlying respiratory disease: impact of multislice CT on image quality and negative predictive value

et al. 2002

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

CT angiography of pulmonary embolism in patients with underlying respiratory disease: impact of multislice CT on image quality and negative predictive value

et al. 2002

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“…The diagnosis of pulmonary embolism on CTPA is based on finding filling defects within the contrast-enhanced lumens of the pulmonary arteries or direct observation of an intra-luminal clot. 15,16 Typical manifestations of embolus on CT include the "lifesaver" sign perpendicular to the long axis of the vessel, the "railway track" sign on longitudinal images of the vessel, and the Westermark sign, which refers to peripheral wedge-shaped regions of ground-glass opacity or consolidation. [17][18][19] However, in our patient the sharp artery cutoff on CTPA (arrow in Fig.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary-Vein Stenosis Can Mimic Massive Pulmonary Embolism After Radiofrequency Ablation for Atrial Fibrillation

Wang¹,

Zhou²,

Wu³

et al. 2011

Respir Care

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“…5,6 Although normal V/Q scintigraphy essentially excludes PE, a high-probability V/Q scan has a sensitivity of 88% for PE compared with pulmonary angiography. In the prospective investigation of pulmonary embolism diagnosis (PIO-PED) study, only 41% of patients with PE had a highprobability scan, 7 and 57% of patients had nondiagnostic (indeterminate or low-probability) V/Q scans.…”

Section: Ct Pulmonary Angiographymentioning

confidence: 99%

Role of Computed Tomography and Magnetic Resonance Imaging for Deep Venous Thrombosis and Pulmonary Embolism

2004

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Abstract-During the 1990s, computed tomography (CT) and magnetic resonance (MR) imaging underwent extensive technological advancement and expanded clinical use in patients with venous thromboembolic disease, particularly with regard to evaluation of the pulmonary vasculature. In many institutions, helical (spiral) CT pulmonary angiography has become the initial imaging study of choice to evaluate patients with suspected pulmonary embolism, supplanting ventilation/perfusion scintigraphy. In addition, CT venography of the pelvis and lower extremities is often incorporated into the CT angiography protocol to identify or exclude concurrent deep venous thrombosis. MR pulmonary angiography and MR venography are second-line diagnostic tools because of their higher cost, limited availability, and other logistical constraints. As the technology improves and becomes more widely available, MR imaging may play a greater role in the evaluation of patients with venous thromboembolic disease. Key Words: thrombosis Ⅲ pulmonary heart disease Ⅲ imaging Ⅲ MRI D uring the 1990s, technological advances in computed tomography (CT) and magnetic resonance (MR) imaging made these techniques applicable to the diagnosis of venous thromboembolic disease, particularly for the pulmonary vasculature in patients with suspected pulmonary embolism (PE). At the opening of the third millennium, in many institutions, helical (spiral) CT pulmonary angiography (CTPA) has become the initial imaging study of choice for evaluating patients with suspected PE, supplanting ventilation/perfusion (V/Q) scintigraphy by reducing indeterminate examinations. 1-4 CT venography (CTV) of the pelvic and lower extremity veins after CTPA of the pulmonary arteries has been advocated by some as an adjunct to helical CT for detection of concurrent deep venous thrombosis (DVT) using a single imaging technique for detection of venous thromboembolic disease.Although MR imaging produces high tissue contrast without ionizing radiation, currently, this technique is less popular than CT for evaluation of acute venous thromboembolism (VTE) because of technical limitations, higher costs, limited availability, and other logistical considerations. As technology improves, however, MR pulmonary angiography (MRPA) and MR venography (MRV) may play a greater role in the evaluation of patients with venous thromboembolic disease.This article reviews applications of CT and MR imaging in the clinical evaluation of patients with suspected venous thromboembolic disease. CT Pulmonary AngiographyCTPA has gained acceptance as a first-line imaging study in cases of suspected acute PE, replacing traditional V/Q scintigraphy at many institutions. In general, V/Q scanning is reserved for patients in whom motion artifact or poor right heart function limit the quality of CT examination and those with contraindications to intravenous radiographic contrast.After contrast administration, CTPA provides visualization of the pulmonary arterial system in the axial plane, and multiplanar and three-dimensional...

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Clinical Value of Thin Collimation in the Diagnostic Workup of Pulmonary Embolism

Cited by 112 publications

References 12 publications

CT angiography of pulmonary embolism in patients with underlying respiratory disease: impact of multislice CT on image quality and negative predictive value

CT angiography of pulmonary embolism in patients with underlying respiratory disease: impact of multislice CT on image quality and negative predictive value

Pulmonary-Vein Stenosis Can Mimic Massive Pulmonary Embolism After Radiofrequency Ablation for Atrial Fibrillation

Role of Computed Tomography and Magnetic Resonance Imaging for Deep Venous Thrombosis and Pulmonary Embolism

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