MDCT of 220 consecutive patients with suspected acute pulmonary embolism: incidence of pulmonary embolism and of other acute or non-acute thoracic findings

Radiol Med. 2008 Apr;113(3):373-84. doi: 10.1007/s11547-008-0262-9. Epub 2008 Jul 9.
[Article in English, Italian]

Abstract

Purpose: This study was undertaken to evaluate the incidence of pulmonary embolism (PE) and other clinically relevant thoracic findings discovered on contrast-enhanced multidetector computed tomography (MDCT) examination in patients with a suspicion of acute PE.

Materials and methods: We retrospectively reviewed 220 reports of 40-row MDCT exams in consecutive patients (101 men, 119 women; mean age 55 years+/-18) suspected for acute PE. Presenting symptoms and risk factors were recorded. Image quality and incidence of PE and other clinically relevant thoracic findings were evaluated.

Results: MDCT were diagnostic in 96.8% of patients. Nineteen patients (8.6%) were positive for PE. Signs and symptoms were present in 82.7% (182) and risk factors in 38.2% (84) of the population. Clinically relevant thoracic findings were detected in 45.9% (101) of the patients. Ten patients had PE and other thoracic findings. Half of the patients (110) had neither PE nor other clinically relevant thoracic findings.

Conclusions: Chest MDCT, with an excellent overall image quality, provided an explanation for the clinical presentation in about 50% of emergency department patients studied and was useful in detecting PE and other thoracic diseases with symptoms mimicking PE. However, half of the exams were negative.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Incidence
  • Italy / epidemiology
  • Lung Diseases / diagnostic imaging
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Pulmonary Embolism / diagnostic imaging*
  • Pulmonary Embolism / epidemiology
  • Radiographic Image Enhancement
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tomography, Spiral Computed / methods*