The analysis of non-thromboembolic findings encountered in multidetector computed tomography pulmonary angiography studies in patients with suspected pulmonary embolism

Battal, Bilal; Karaman, Bülent; Gümüş, Seyfettin; Akgün, Veysel; Bozlar, Uğur; Taşar, Mustafa

doi:10.5505/tatd.2011.90377

Cited by 3 publications

(4 citation statements)

References 12 publications

(22 reference statements)

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“…Again, that study reported findings that were both related to patient's signs and symptoms (62.5%) and were only incidental pathologies (37.5%). MSCT could not detect any abnormality in 43 (21.8%) cases (22). Richman et al researched 1025 patients who had suspected PE and found that 104 patients had PE and 921 patients had no PE.…”

Section: Discussionmentioning

confidence: 99%

Multislice Computed Tomography Findings of Patients with Suspected Pulmonary Embolism in the Emergency Department: Incidence of Pulmonary Embolism and Non-Thromboembolic Findings

Ergönül¹,

Ayrık²,

Köse³

et al. 2015

West Indian Med J

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Objective: This study aimed to evaluate the incidence of pulmonary embolism (PE) and tomographic findings in patients who underwent multislice computed tomography (MSCT) for suspected PE in the emergency department. Methods:We assessed the radiologic and medical records of 212 cases undergoing MSCT for suspected PE in the emergency department for a period of 16 months. A total of 201 cases were included in the final analysis. Age, sex, admission symptoms, risk factors, and MSCT findings were recorded. The final diagnosis assigned to each patient was determined. Results:The PE incidence was found to be 24,4%. Forty-nine (24,4%) of the cases were diagnosed with PE, while 152 (75,6%) had non-thromboembolic pathologies. There was no statistically significant difference between the patients with and without PE with respect to mean age, symptom status and gender (p>0.05). Among the risk factors for PE, only presence of previous surgical operation was statistically significant. Forty-three (87,7%) of the cases with PE and 118 (77,6%) of those without PE had additional parenchymal abnormalities.Linear atelectasis was the only significant difference in MSCT between patients with PE and those without PE (p<0.001).

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Section: Discussionmentioning

confidence: 99%

Multislice Computed Tomography Findings of Patients with Suspected Pulmonary Embolism in the Emergency Department: Incidence of Pulmonary Embolism and Non-Thromboembolic Findings

Ergönül¹,

Ayrık²,

Köse³

et al. 2015

West Indian Med J

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“…Diagnosis of PTE can be masked by comorbidities (4). Invasive pulmonary angiography has been accepted as the gold standard for the diagnosis of PTE; however, its use is limited due to its high mortality rate (0.5%), invasiveness, expense and requirement for specialized infrastructure that may not be available in all centers (5).…”

Section: Introductionmentioning

confidence: 99%

Investigating the Use and Optimization of Low Dose kV and Contrast Media in CT Pulmonary Angiography Examination

et al. 2018

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Background: Using a low volume of contrast medium and tube voltage may enhance the opacification of pulmonary arteries and thrombus detection without decreasing the image quality. In addition, this protocol can also ensure that exposure of the patient to the contrast medium and radiation dose may be significantly reduced. Objectives: The purpose of this study was to investigate the efficiency of low tube voltage and low dose iodine-based contrast medium in computed tomography pulmonary angiography (CTPA) and optimize its use in the diagnosis of pulmonary thromboembolism (PTE). Patients and Methods: We included a total of 100 patients undergoing CTPA with an initial diagnosis of PTE into two groups: group A (n = 50) was given a contrast medium (CM) dose of 0.5 mL/kg at 80 kV while group B (n = 50) was given a CM dose of 1 mL/kg at 100 kV. Bolus tracking technique was used. Attenuation values were measured from the center of different pulmonary arterial segments. Values over 350 Hounsfield unit (HU) were accepted as significant. Image qualities of all pulmonary arterial segments were sufficient for diagnosis. The mean and effective doses of radiation received by patients in the two groups were compared. Results: PTE was detected in twenty-one patients (21%) in both groups. Total mean attenuation values for pulmonary arteries were significantly higher in group A than in group B (532.7 ± 243 HU vs. 380.6 ± 232 HU respectively, P < 0.001). Total dose length product (DLP) (76.5 ± 17.3 mGy.cm vs. 162.1 ± 31.3 mGy.cm, P < 0.001) and effective dose values (1.2 ± 0.2 mSv vs. 2.4 ± 0.2 mSv, P < 0.001) were significantly lower in group A compared to group B. Conclusion: CTPA may be obtained using an imaging protocol with low kV and reduced volume of contrast medium in the diagnosis of PTE.

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“…1 Clinically, PE ranges from anatomically small and clinically asymptomatic emboli to massive proximal emboli with cardiogenic shock. 2,3 Since early treatment is vital, immediate and correct diagnosis is important. 4 Helical computed tomography (CT) of the pulmonary arteries has become the first-line technique for the detection of emboli in the large and segmental vessels.…”

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confidence: 99%

“…4 Helical computed tomography (CT) of the pulmonary arteries has become the first-line technique for the detection of emboli in the large and segmental vessels. 3,5,6 The European Society of Cardiology recently included computed tomography pulmonary angiography (CTPA) as the reference standard modality to be used following initial clinical evaluation. 7 PE is diagnosed by demonstrating a filling defect in the pulmonary arteries.…”

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confidence: 99%

Correlation of Computerized Tomography Angiographic Pulmonary Artery Obstruction Score with Hematologic Outcome and Mortality in Patients with Acute Pulmonary Embolism

Yesildag¹,

Keskin²,

Güler³

et al. 2013

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The aim of this study was to determine the relationship between the computed tomography obstruction score and radiological parameters, biochemical parameters, and mortality. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : During an 8-month period (January 2011-August 2011), 326 patients with clinically suspected pulmonary embolism (PE) were examined by computerized tomography pulmonary angiography (CTPA). Of these patients, only 95 (49 men and 46 women) were diagnosed with PE. Computerized tomography images were retrieved from the picture archiving and communication system (PACS) for the determination of right ventricle/left ventricle (RV/LV) shortaxis ratio, maximum diameter of the pulmonary artery, and vascular obstruction score according to Qanadli method. We investigated the correlation between continuous values of the Qanadli scoring system and mortality, and determined whether there was a significant difference between mortality and CTPA parameters. The values derived from the morphologic changes in the CTPA, hematological findings and gender where then assessed with respect to their impacts on mortality. R Re es su ul lt ts s: : There was a significant correlation between the PE obstruction score and RV/LV short-axis ratio (r=0.58, p<0.001), RV/LV short-axis ratio, and neutrophil to lymphocyte ratio (NLR) (r=0.21, p=0.035). Survivors and non-survivors had a statistically significant difference in the NLR and midplatelet volume (MPV) (p<0.05). The mortality incidence in patients with an increased MPV (odds ratio 1.689; 95% confidence interval (CI) 1.06-2.67; p=0.025) and older female patients (odds ratio 3.732; 95% CI 1.02-13.65; p=0.04) was higher. C Co on nc cl lu us si io on n: : Our results suggest that in patients with acute PE, NLR and MPV may be of value for the estimation of mortality.K Ke ey y W Wo or rd ds s: : Pulmonary embolism; multidetector computed tomography Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmanın amacı, bilgisayarlı tomografi obstrüksiyon skoru ile radyolojik, biyokimyasal parametreler ve mortalite arasındaki ilişkiyi belirlemektir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Sekiz aylık periyotta (Ocak 2011-Ağustos 2011), klinik olarak pulmoner emboli kuşkulu 326 hasta bilgisayarlı tomografi pulmoner anjiyografi (BTPA) ile incelendi. Bunların sadece 95'i (49 erkek, 46 kadın) pulmoner emboli tanısı aldı. Bilgisayarlı tomografi imajları sağ ventrikül/sol ventrikül kısa aks oranlarını, pulmoner arter maksimum çapını ve Qanadli obstrüksiyon skorunu saptamak için gö-rüntü saklama ve iletişim sisteminden çağrıldı. Qanadli obstrüksiyon skoru ile mortalite arasındaki ilişki incelendi. Mortalite ve bilgisayarlı tomografi pulmoner anjiyografi parametreleri arasında anlamlı farklılık olup olmadığı araştırıldı. Bilgisayarlı tomografi pulmoner anjiyografideki morfolojik değişikliklerden elde edilen değerler, hematolojik bulgular, cinsiyet ve bunların mortalite üzerin-deki etkileri değerlendirildi. B Bu ul lg gu ul la ar r...

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The analysis of non-thromboembolic findings encountered in multidetector computed tomography pulmonary angiography studies in patients with suspected pulmonary embolism

Cited by 3 publications

References 12 publications

Multislice Computed Tomography Findings of Patients with Suspected Pulmonary Embolism in the Emergency Department: Incidence of Pulmonary Embolism and Non-Thromboembolic Findings

Multislice Computed Tomography Findings of Patients with Suspected Pulmonary Embolism in the Emergency Department: Incidence of Pulmonary Embolism and Non-Thromboembolic Findings

Investigating the Use and Optimization of Low Dose kV and Contrast Media in CT Pulmonary Angiography Examination

Correlation of Computerized Tomography Angiographic Pulmonary Artery Obstruction Score with Hematologic Outcome and Mortality in Patients with Acute Pulmonary Embolism

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