The role of spiral volumetric computed tomography in the diagnosis of pulmonary embolism

Arch Intern Med. 2000 Feb 14;160(3):293-8. doi: 10.1001/archinte.160.3.293.


To evaluate the evidence for the use of spiral volumetric computed tomography (SVCT) in the diagnosis of acute pulmonary embolism (PE), the 11 English-language studies published through July 1998 that compared SVCT with a reference standard for PE were systematically reviewed. Among the reviewed studies, methodological problems were common. Only 5 of these studies fulfilled 5 of 11 basic standards addressing important issues in diagnostic test research. The reported sensitivities of SVCT compared with pulmonary angiography varied widely (64%-93%), which was likely the result of differences in study populations. Spiral volumetric computed tomography may be relatively sensitive and specific for diagnosing central pulmonary artery PEs, but it is insensitive for diagnosing subsegmental clots. Spiral volumetric computed tomography may have a role as a "rule-in" test for large central emboli, but additional research is required to establish its place in clinical practice.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Acute Disease
  • Humans
  • Pulmonary Artery / diagnostic imaging
  • Pulmonary Embolism / diagnostic imaging*
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed / methods*