Clinical outcomes of patients after a negative spiral CT pulmonary arteriogram in the evaluation of acute pulmonary embolism

J Vasc Interv Radiol. 1999 Jun;10(6):707-12. doi: 10.1016/s1051-0443(99)70104-1.


Purpose: To examine 6-month clinical outcomes of patients after acquisition of a spiral computed tomography (CT) pulmonary arteriogram interpreted as negative for acute pulmonary embolism (PE).

Materials and methods: A retrospective review was performed on a consecutive series of 143 patients who underwent spiral CT pulmonary arteriography for possible acute PE during a 19-month period. All studies were performed on a HiSpeed Scanner with use of 3-mm collimation with a pitch between 1.3 and 2.0, depending on patient size. All imaging was performed during dynamic contrast material injection at rates between 3.0 and 4.0 mL/sec, timed to peak pulmonary arterial enhancement. For the studies interpreted as negative for PE through the segmental (fourth order) pulmonary arteries, follow-up data were collected by telephone interviews with patients or surviving relatives, and by medical record reviews.

Results: Among 143 patients, 22 studies (15%) were positive for PE, eight (6%) were suboptimal to exclude PE to the segmental artery level, and 113 (79%) were interpreted as negative for acute PE. Among the 113 negative studies, 13 patients were lost to follow-up, leaving a study population of 100 patients. Eighty-one patients were alive a minimum of 6 months after acquisition of a negative spiral CT pulmonary arteriogram (mean, 9 months; range, 6-24 months) and were without interim diagnosis of PE. Nineteen patients died within the follow-up period after a negative spiral CT pulmonary arteriogram (mean, 3 months; range, 0-8 months); however, in none of these cases was acute pulmonary embolus reported as the cause of death. No documented PE was identified by subsequent imaging studies or autopsy within the study population.

Conclusion: A series of 100 patients with a negative spiral CT pulmonary arteriogram did not experience significant morbidity and mortality as a result of pulmonary embolic disease within a 6-month follow-up period.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography / methods*
  • Cause of Death
  • Contrast Media / administration & dosage
  • Follow-Up Studies
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Interviews as Topic
  • Lung / blood supply*
  • Middle Aged
  • Outcome Assessment, Health Care
  • Pulmonary Embolism / diagnostic imaging*
  • Radiographic Image Enhancement / methods
  • Retrospective Studies
  • Survival Rate
  • Tomography, X-Ray Computed / methods*
  • Ultrasonography, Doppler, Duplex
  • Venous Thrombosis / diagnostic imaging
  • Ventilation-Perfusion Ratio


  • Contrast Media