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

TCMD di 220 pazienti consecutivi con sospetto di embolia polmonare acuta: incidenza di embolia polmonare e di altri reperti toracici acuti o non acuti

La radiologia medica volume 113, pages 373–384 (2008)Cite this article

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

Riassunto

Obiettivo. Scopo dello studio è valutare l’incidenza di embolia polmonare (EP) e di altri reperti toracici clinicamente rilevanti, in esami di tomografia computerizzata multi-detettore (TCMD) con mezzo di contrasto, in pazienti con sospetta embolia polmonare acuta

Materiali e metodi. Abbiamo analizzato retrospettivamente i referti TC 40-strati di 220 pazienti consecutivi (101 maschi, 119 femmine; età media 55±18 anni) con sospetto di EP acuta. Sono stati raccolti sintomi e fattori di rischio. Abbiamo valutato la qualità delle immagini e l’incidenza di EP e di altri reperti toracici clinicamente rilevanti. Risultati. La TCMD è risultata diagnostica nel 96,8% dei pazienti. L’82,7% (n=182) dei pazienti aveva segni/sintomi, il 38,2% (n=84) fattori di rischio. All’8,6% dei pazienti (n=19) è stata fatta diagnosi di embolia polmonare, al 45,9% (n=101) sono stati identificati altri reperti toracici clinicamente rilevanti. Dieci pazienti avevano sia EP sia altri reperti toracici. Metà della popolazione (n=110) non aveva né EP né altri reperti toracici clinicamente rilevanti

Risultati. La TCMD è risultata diagnostica nel 96,8% dei pazienti. L’82,7% (n=182) dei pazienti aveva segni/sintomi, il 38,2% (n=84) fattori di rischio. All’8,6% dei pazienti (n=19) è stata fatta diagnosi di embolia polmonare, al 45,9% (n=101) sono stati identificati altri reperti toracici clinicamente rilevanti. Dieci pazienti avevano sia EP sia altri reperti toracici. Metà della popolazione (n=110) non aveva né EP né altri reperti toracici clinicamente rilevanti

Conclusioni. La 40-TCMD del torace, grazie anche ad un’eccellente qualità dell’immagine, ha fornito una spiegazione alla presentazione clinica in circa metà dei pazienti studiati, risultando utile nell’identificazione dell’embolia polmonare e di altre patologie toraciche con sintomi simili. Tuttavia la metà degli esami è risultata negativa

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University of Milan, San Paolo Hospital, Via A. Di Rudinì 8, 20142, Milan, Italy

    S. Tresoldi

  2. Department of Radiology, Umass Memorial Medical Center, University of Massachusetts, 55 Lake Avenue North, Worcester, MA, 01655, USA

    Y. H. Kim & K. Kandarpa

  3. IS Bioinformatics Unit, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA

    S. P. Baker

Authors
  1. S. Tresoldi
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  2. Y. H. Kim
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Correspondence to S. Tresoldi.

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Tresoldi, S., Kim, Y.H., Baker, S.P. et al. 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 113, 373–384 (2008). https://doi.org/10.1007/s11547-008-0262-9

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  • DOI: https://doi.org/10.1007/s11547-008-0262-9

Keywords

  • Thoracic diseases
  • Pulmonary artery
  • Pulmonary embolism
  • Computed tomography

Parole chiave

  • Patologia toracica
  • Arteria polmonare
  • Embolia polmonare
  • Tomografia computerizzata