Radiologic mimics of pulmonary embolism

Matusov, Yuri; Tapson, Victor F.

doi:10.1080/00325481.2021.1931370

Cited by 5 publications

(5 citation statements)

References 100 publications

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“…There are multiple known causes of false-positives for pulmonary emboli on ventilation/ perfusion scintigraphy, including pulmonary artery compression by masses or hemorrhage, vasculitic processes, and inadequate imaging technique. [8][9][10][11] In this case, improper patient positioning during tracer administration resulted in false-positive mismatched perfusion defects symmetrically at the lung apices. This case demonstrates the importance of following all protocol parameters during the conduct of nuclear medicine procedures, including patient positioning, as well as the importance of quality control when unusual findings are seen on imaging.…”

mentioning

confidence: 82%

“…The study was deemed normal by PIOPED 2 criteria, without evidence for pulmonary emboli. There are multiple known causes of false-positives for pulmonary emboli on ventilation/perfusion scintigraphy, including pulmonary artery compression by masses or hemorrhage, vasculitic processes, and inadequate imaging technique 8–11 . In this case, improper patient positioning during tracer administration resulted in false-positive mismatched perfusion defects symmetrically at the lung apices.…”

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confidence: 93%

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False-Positive for Pulmonary Emboli on Ventilation/Perfusion Scan Due to Improper Patient Positioning During Tracer Administration

Ulaner

Grigore

2022

Clin Nucl Med

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A 67-year-old woman presented with shortness of breath and a ventilation/perfusion scan was performed. Initial images demonstrated mismatched bilateral apical defects that would be classified as high probability for pulmonary emboli. However, it was unusual that the defects were only in the bilateral apices. Investigation discovered that 99mTc-MAA was administered while the patient was in a seated position. Repeat scan the following day with the patient in the correct, supine, position during 99mTc-MAA administration demonstrated no defects. In this case, incorrect patient positioning could have resulted in an incorrect diagnosis of pulmonary emboli and inappropriate treatment of the patient.

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confidence: 82%

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confidence: 93%

False-Positive for Pulmonary Emboli on Ventilation/Perfusion Scan Due to Improper Patient Positioning During Tracer Administration

Ulaner

Grigore

2022

Clin Nucl Med

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“…Pulmonary imaging studies for FES include chest plain films and thoracic/lung CT scans. Radiological abnormalities develop gradually and commonly exhibit diffuse "fluffy" bilateral infiltrates (snowstorm appearance), predominantly in the lung bases and the periphery [16]. The use of thoracic and lung CT scans may be particularly helpful in patients with symptoms compatible with FES and relatively normal chest X-rays (i.e., small lung infarcts/lesions).…”

Section: Clinical Manifestations and Diagnosismentioning

confidence: 99%

“…Considering that pulmonary FE is not as common and can resemble many other pulmonary and/or systemic inflammatory conditions, it is important to consider the differential diagnoses before making the diagnosis of fat embolism [16]. On CT, the differential diagnosis of parenchymal findings of FES may include pulmonary contusion, edema, thromboembolic pulmonary embolism, aspiration, and pneumonia.…”

Section: Thoracic Ct Differential Diagnosis Of Fesmentioning

confidence: 99%

Imaging Findings in Pulmonary Fat Embolism: Literature Review and Practical Aspects

Botero

2023

IJOPRS

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Fat embolism syndrome is an uncommon but potentially fatal condition associated with trauma or long bone surgery, which presents predominantly with pulmonary symptoms. While medical advances have resulted in a reduction in mortality rates, the accurate diagnosis of the condition remains challenging due to its ability to mimic other causes of respiratory distress. Since the symptoms, laboratory tests, and imaging studies are often nonspecific, the identification of fat embolism must be based on a combination of these elements. The use of pulmonary imaging techniques, particularly chest computed tomography, is crucial to the assessment of this condition. When hypoxia occurs after surgery or trauma, the presence of diffuse and well-defined ground glass opacities or centrilobular nodules on CT are highly suggestive of fat embolism. As this disorder is mainly managed via supportive measures, prevention and early identification are essential to improving patient outcomes. This review describes the main clinical and imaging aspects of pulmonary fat embolism.

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“…Therefore, the possibility of overdiagnosing this grave illness can stem from cognitive biases shaped by the severity of the disease, the significance of early intervention, and mortality statistics. 2 …”

Section: Introductionmentioning

confidence: 99%

The Harms of Unnecessary CT Pulmonary Angiography: A Case Report and Literature Review

Alagha,

Bills,

Alastal

et al. 2024

Journal of Investigative Medicine High Impact Case Reports

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Pulmonary embolism (PE) poses a significant health risk in the United States, with high mortality rates. Clinicians maintain a low threshold for suspecting PE, potentially leading to deviation from guideline-recommended algorithms and unnecessary computed tomography pulmonary angiography (CTPA). This case discusses a 46-year-old woman who presented with symptoms suggestive of PE following a prolonged road trip. Despite a low Wells score and negative D-dimer results, she underwent CTPA, resulting in an unnecessary and harmful interventional radiology–guided thrombectomy. This highlights the importance of adhering to guidelines in PE diagnosis to mitigate potential harms associated with the overuse of available medical tools.

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Radiologic mimics of pulmonary embolism

Cited by 5 publications

References 100 publications

False-Positive for Pulmonary Emboli on Ventilation/Perfusion Scan Due to Improper Patient Positioning During Tracer Administration

False-Positive for Pulmonary Emboli on Ventilation/Perfusion Scan Due to Improper Patient Positioning During Tracer Administration

Imaging Findings in Pulmonary Fat Embolism: Literature Review and Practical Aspects

The Harms of Unnecessary CT Pulmonary Angiography: A Case Report and Literature Review

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