Résumé
Objectif
La pratique de l’angioscanner thoracique spiralé (angio-TDM) a considérablement amélioré la performance des procédures diagnostiques d’embolie pulmonaire (EP). La typologie des diagnostics alternatifs retrouvés lors de cet examen est peu décrite. L’objet de notre étude est de décrire quelles anomalies sont détectées lors d’angioscanners réalisés pour le diagnostic d’EP.
Matériel et méthodes
Étude rétrospective monocentrique sur deux années (1er janvier 2005–31 décembre 2006); description des éléments retrouvés par l’angio-TDM chez les patients suspects d’EP et caractérisation des populations selon la catégorie diagnostique: EP présente, EP absente avec anomalie significative, EP absente sans anomalie significative, pas d’anomalie.
Résultats
Une EP était diagnostiquée chez 84 (19 %) des 431 patients analysables; 156 (36 %) avaient un angioscanner normal, 45 (11 %) l’absence d’anomalie significative. Cent quarante-six (34 %) présentaient des anomalies significatives, majoritairement représentées par une pneumonie aiguë communautaire (n = 63, 44 %), un cancer (n = 32, 22 %) et des lésions de bronchopathie chronique obstructive (n = 32, 22 %).
Conclusion
La réalisation d’un angio-TDM permet de diagnostiquer des anomalies significatives chez 45 % des patients suspects d’EP consultant aux urgences.
Abstract
Aim
CT pulmonary angiography (CTPA) has improved diagnosis procedure in patients with suspected pulmonary embolism (PE). The typology of other findings has been poorly described.
Material and methods
To retrospectively describe findings obtained by CTPA in patients with suspected PE during a two-year period (1st of January, 2005 to 31st of December, 2006) in the emergency department of a tertiary teaching hospital, and to describe populations associated with the various diagnosis categories: PE, non-PE with significant abnormalities, non-PE with non-relevant abnormalities, and normal CTPA.
Results
PE was diagnosed in 84 (19%) of the 431 patients that could be analyzed; 156 (36%) had normal CTPA, 45 (11%) non-relevant abnormalities, and 146 (34%) patients with relevant abnormalities, mainly represented by infections (N = 63, 44%), cancer (N = 32, 22%) and COPD (N = 32, 22%).
Conclusion
Relevant findings are diagnosed in 45% of the patients visiting the emergency department with suspicion of PE.
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Clément, H., Feydy, A., André, S. et al. Quels sont les diagnostics retenus après angioscanner thoracique chez les patients des urgences suspects d’embolie pulmonaire ?. Ann. Fr. Med. Urgence 1, 21–25 (2011). https://doi.org/10.1007/s13341-010-0015-4
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DOI: https://doi.org/10.1007/s13341-010-0015-4