Computed tomography pulmonary angiography using high-pitch dual-source scanner technology

Hassan, Donya Al; Waheed, Khawaja Bilal; Sirafy, M.N. El; Khattab, Mohamad A. A.; Al-Hammadi, Hassan I.; Ibrahim, Motassem F.; Arulanantham, Zechariah Jebakumar

doi:10.15537/smj.2019.3.23940

Cited by 7 publications

(6 citation statements)

References 31 publications

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“…Studies comparing the high-pitch and routine scanning for pulmonary embolism CT have shown improved image quality, decreased artifacts, and decreased radiation dose with high-pitch imaging [6,7]. This improvement in image quality is associated with better delineation of cardiovascular structures.…”

Section: Introductionmentioning

confidence: 99%

Imaging of the aortic root on high-pitch non-gated and ECG-gated CT: awareness is the key!

et al. 2020

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The aortic pathologies are well recognized on imaging. However, conventionally cardiac and proximal aortic abnormalities were only seen on dedicated cardiac or aortic studies due to need for ECG gating. Advances in CT technology have allowed motionless imaging of the chest and abdomen, leading to an increased visualization of cardiac and aortic root diseases on non-ECG-gated imaging. The advances are mostly driven by high pitch due to faster gantry rotation and table speed. The high-pitch scans are being increasingly used for variety of clinical indications because the images are free of motion artifact (both breathing and pulsation) as well as decreased radiation dose. Recognition of aortic root pathologies may be challenging due to lack of familiarity of radiologists with disease spectrum and their imaging appearance. It is important to recognize some of these conditions as early diagnosis and intervention is key to improving prognosis. We present a comprehensive review of proximal aortic anatomy, pathologies commonly seen at the aortic root, and their imaging appearances to familiarize radiologists with the diseases of this location.

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Section: Introductionmentioning

confidence: 99%

Imaging of the aortic root on high-pitch non-gated and ECG-gated CT: awareness is the key!

et al. 2020

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“…However, there may be significant discordance (25%) among radiologists when assessing small subsegmental contrast filling defects. [37] Our results are adequately validated since all CTPA studies were reported by a single experienced radiologist. Moreover, we excluded all poor quality CTPA cases from our study.…”

Section: Discussionmentioning

confidence: 55%

“…However, there may be significant discordance (25%) among radiologists when assessing small subsegmental contrast filling defects. [ 37 ]…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic yield of CT pulmonary angiography for pulmonary embolism in clinically suspected patients

Alshumrani¹,

Bshabshe

Mousa³

2021

Medicine

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Pulmonary embolism (PE) is a common medical problem. Its diagnostic criteria must be reviewed to determine the need for confirmatory testing. Computed tomography pulmonary angiography (CTPA) is the current standard of care, which provides accurate diagnosis with rapid turnaround. This study aimed to estimate the diagnostic yield of CTPA in clinically suspected PE patients in a tertiary care hospital in Saudi Arabia. Radiology records of all patients with clinically suspected PE who underwent CTPA between January 1, 2012 and September 30, 2018 were reviewed retrospectively. A radiologist with 10 years of professional experience interpreted and reported all cases. The Wells score with 2 tiers (likely and unlikely) was used to raise the clinical suspicion of PE. Positive results for PE were reported in 177 out of 534 clinically suspected cases (33%). Among the positive PE cases, 143 were acute (81%) and 34 (19%) were chronic. Bilateral, right-sided, and left-sided PE were found in 115 (65%), 37 (21%), and 25 (14%) cases, respectively. Involvement of the segmental branches, subsegmental branches, and the pulmonary trunk were noted in 152 (86%), 70 (40%), and 9 cases (5%), respectively. Saddle PE was found in (4%) of the cases. The lower lobe branches (right 55%, left 53%) and the upper lobe branches (right 47%, left 41%) were the most common sites of involvement. CTPA had a higher positive detection rate for PE among clinically suspected cases than its published diagnostic yield. Adequate clinical evaluation when selecting patients for CTPA is emphasized to minimize unjustified exposure of the patients to radiation and intravenous contrast administration. It is crucial for radiologists to provide detailed reports commenting on all relevant findings, including pertinent negatives. A template for reporting radiological findings for CTPA can be recommended for this purpose.

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“…It is capable of directly visualizing emboli and may even provide an alternate diagnosis. 18 There are concerns over increased availability of CTPA leading to its overuse in diagnostic workup of patients having cardio-respiratory symptoms. 19 However, in case of positive D-dimers and high or a "likely" clinical probability, CT pulmonary angiography is now the recommended imaging technique.…”

Section: Discussionmentioning

confidence: 99%

Comparison of 128-Slice Spiral Computed Tomography Pulmonary Angiography (Ctpa) Findings With Plasma D-Dimer Levels in Patients With Clinical Suspicion of Pulmonary Embolism

Nisar

Nasir

Slehria

et al. 2021

PAFMJ

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Objective: To compare the effectiveness of plasma D-dimer levels with findings of 128-slice spiral computed tomography pulmonary angiography (CTPA) in patients with clinical suspicion of pulmonary embolism. Study Design: Retrospective observational study Place and Duration of Study: Department of Computed Tomography, Armed Forces Institute of Radiology & Imaging, Pak Emirates Military Hospital Rawalpindi, from Jan 2018 to Dec 2018. Methodology: A total of 59 patients were inducted who presented in Emergency Department, Pak Emirates Military Hospital Rawalpindi with clinical suspicion of Pulmonary Embolism. The main symptoms were shortness of breath and chest pain. Plasma D-dimer levels of all patients were sent to laboratory and CTPA was performed at Computed Tomography department, Armed Forces Institute of Radiology & Imaging using 128-slice spiral computed tomography. Results: 36 patients (61%) were males and 23 (39%) were females with an average age of 48.03 ± 18.06 years (range 23-85 years). Out of 59 patients, D-dimer levels were raised in 28 cases (47.4%) while 31 patients (52.6%) showed normal levels. Pulmonary Embolism was detected by CTPA in 30 cases (50.8%) while 29 patients (49.2%) were without obvious abnormality. Conclusion: Plasma D-Dimer levels show low sensitivity, specificity and negative predictive value and cannot exclude Pulmonary Embolism without CTPA. Computed Tomography Pulmonary Angiography (CTPA) remains diagnostic modality of choice for definitive assessment of Pulmonary Embolism in patients reporting at the emergency reception.

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Computed tomography pulmonary angiography using high-pitch dual-source scanner technology

Cited by 7 publications

References 31 publications

Imaging of the aortic root on high-pitch non-gated and ECG-gated CT: awareness is the key!

Imaging of the aortic root on high-pitch non-gated and ECG-gated CT: awareness is the key!

Diagnostic yield of CT pulmonary angiography for pulmonary embolism in clinically suspected patients

Comparison of 128-Slice Spiral Computed Tomography Pulmonary Angiography (Ctpa) Findings With Plasma D-Dimer Levels in Patients With Clinical Suspicion of Pulmonary Embolism

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