Role of Helical CT Pulmonary Angiography in Risk Stratification for Patients With Pulmonary Embolism

2011 ◽  
Vol 18 (5) ◽  
pp. 230-237
Author(s):  
Thomas H. Urbania ◽  
Michael B. Gotway ◽  
Michael D. Hope ◽  
David M. Naeger ◽  
Karen G. Ordovas ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Risk Stratification ◽  
Helical Ct ◽  
Pulmonary Angiography ◽  
Ct Pulmonary Angiography

scholarly journals CT Pulmonary Angiography for Risk Stratification of Patients with Nonmassive Acute Pulmonary Embolism

2020 ◽  
Vol 2 (4) ◽  
pp. e190188
Author(s):  
David C. Rotzinger ◽  
Jean-François Knebel ◽  
Anne-Marie Jouannic ◽  
Ghazal Adler ◽  
Salah D. Qanadli
Keyword(s):  
Pulmonary Embolism ◽  
Risk Stratification ◽  
Acute Pulmonary Embolism ◽  
Pulmonary Angiography ◽  
Ct Pulmonary Angiography

Helical CT Pulmonary Angiography Predictors of In-Hospital Morbidity and Mortality in Patients With Acute Pulmonary Embolism

2003 ◽  
Vol 18 (4) ◽  
pp. 207-216 ◽  
Author(s):  
Philip A. Araoz ◽  
Michael B. Gotway ◽  
Robert L. Trowbridge ◽  
Richard A. Bailey ◽  
Andrew D. Auerbach ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Helical Ct ◽  
Pulmonary Angiography ◽  
Morbidity And Mortality ◽  
Ct Pulmonary Angiography ◽  
Hospital Morbidity

A Systematic Review of Double Low-dose CT Pulmonary Angiography in Pulmonary Embolism

2019 ◽  
Vol 15 (5) ◽  
pp. 453-460 ◽  
Author(s):  
Sultan Aldosari ◽  
Zhonghua Sun
Keyword(s):  
Systematic Review ◽  
Pulmonary Embolism ◽  
Image Quality ◽  
Radiation Dose ◽  
Contrast Medium ◽  
Low Dose ◽  
Pulmonary Angiography ◽  
Ct Pulmonary Angiography ◽  
Low Contrast ◽  
Low Contrast Medium

Background: The aim of this study is to perform a systematic review of the feasibility and clinical application of double low-dose CT pulmonary angiography (CTPA) in the diagnosis of patients with suspected pulmonary embolism. Discussion: A total of 13 studies were found to meet selection criteria reporting both low radiation dose (70 or 80 kVp versus 100 or 120 kVp) and low contrast medium dose CTPA protocols. Lowdose CTPA resulted in radiation dose reduction from 29.6% to 87.5% in 12 studies (range: 0.4 to 23.5 mSv), while in one study, radiation dose was increased in the dual-energy CT group when compared to the standard 120 kVp group. CTPA with use of low contrast medium volume (range: 20 to 75 ml) was compared to standard CTPA (range: 50 to 101 ml) in 12 studies with reduction between 25 and 67%, while in the remaining study, low iodine concentration was used with 23% dose reduction achieved. Quantitative assessment of image quality (in terms of signal-to-noise ratio and contrast-to-noise ratio) showed that low-dose CTPA was associated with higher, lower and no change in image quality in 3, 3 and 6 studies, respectively when compared to the standard CTPA protocol. The subjective assessment indicated similar image quality in 11 studies between low-dose and standard CTPA groups, and improved image quality in 1 study with low-dose CTPA. Conclusion: This review shows that double low-dose CTPA is feasible in the diagnosis of pulmonary embolism with significant reductions in both radiation and contrast medium doses, without compromising diagnostic image quality.

scholarly journals Pulmonary embolism during the COVID-19 pandemic

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
BV Silva ◽  
T Rodrigues ◽  
N Cunha ◽  
J Brito ◽  
P Alves Da Silva ◽  
...  
Keyword(s):  
Physical Activity ◽  
Pulmonary Embolism ◽  
Hospital Admissions ◽  
Reference Group ◽  
Group Versus ◽  
Pulmonary Angiography ◽  
Reference Period ◽  
Funding Sources ◽  
Clinical Probability

Abstract Funding Acknowledgements Type of funding sources: None. Background During the COVID-19 pandemic many countries have imposed lockdown restrictions to movement. Since the 18th of March in Portugal, thousands of people have been confined to their homes. While hospital admissions for COVID-19 patients increased exponentially, admissions for non-COVID-19 patients decreased dramatically. However, it remains unclear whether lockdown-related immobility can contribute to the increased incidence of pulmonary embolism. Purpose To compare the incidence of pulmonary embolism (PE) during the lockdown period (Abril 1 to May 31, 2020) compared to the reference period in 2019. Methods Retrospective study of consecutive outpatients who presented to the emergency department and underwent computed tomography pulmonary angiography (CTPA) due to suspicion of PE. Results Compared to the same period of 2019, the lockdown period was associated with a significant increase in PE diagnosis (29 versus 18 patients). PE patients during lockdown were older (median age 71 years; interquartile range [IQR][60-85] versus 59 years [44-76]; p = 0.046) and have lower prevalence of active cancer (14% versus 33% in the reference period). Women represent 55% (n = 16) of patients in lockdown group (versus 50% in 2019 group). Clinical probability (GENEVA score) was similar in both groups (median score 2.72 in lockdown group and 2.50 in reference group, p = 0.452). None of the patients with PE was diagnosed with COVID-19. Conclusion We have observed a marked increase (62%) in PE diagnosis during lockdown period compared to the reference period, which can be explained by the reduction in physical activity due to teleworking and closure of gyms and sports activities. These data reinforce the importance of promoting physical activity programs at home. The role of pharmacological or mechanical thromboprophylaxis in this scenario remains unclear.

scholarly journals COVID-19-induced vascular angiopathy: CTPA signs in critically ill patients other than acute pulmonary embolism and high-lung opacity scores

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Mohamed Hossameldin khalifa ◽  
Ahmed Samir ◽  
Ayman Ibrahim Baess ◽  
Sara Samy Hendawi
Keyword(s):  
Artificial Intelligence ◽  
Pulmonary Embolism ◽  
Lung Volume ◽  
Acute Pulmonary Embolism ◽  
Pulmonary Angiography ◽  
Vascular Tree ◽  
Ct Pulmonary Angiography ◽  
Artificial Intelligence System ◽  
Intelligence System ◽  
Severity Scores

Abstract Background Vascular angiopathy is suggested to be the major cause of silent hypoxia among COVID-19 patients without severe parenchymal involvement. However, pulmonologists and clinicians in intensive care units become confused when they encounter acute respiratory deterioration with neither severe parenchymal lung involvement nor acute pulmonary embolism. Other radiological vascular signs might solve this confusion. This study investigated other indirect vascular angiopathy signs on CT pulmonary angiography (CTPA) and involved a novel statistical analysis that was performed to determine the significance of associations between these signs and the CT opacity score of the pathological lung volume, which is calculated by an artificial intelligence system. Results The study was conducted retrospectively, during September and October 2020, on 73 patients with critical COVID-19 who were admitted to the ICU with progressive dyspnea and low O2 saturation on room air (PaO2 < 93%). They included 53 males and 20 females (73%:27%), and their age ranged from 18 to 88 years (mean ± SD=53.3 ± 13.5). CT-pulmonary angiography was performed for all patients, and an artificial intelligence system was utilized to quantitatively assess the diseased lung volume. The radiological data were analyzed by three expert consultant radiologists to reach consensus. A low CT opacity score (≤10) was found in 18 patients (24.7%), while a high CT opacity score (>10) was found in 55 patients (75.3%). Pulmonary embolism was found in 24 patients (32.9%); three of them had low CT opacity scores. Four other indirect vasculopathy CTPA signs were identified: (1) pulmonary vascular enlargement (57 patients—78.1%), (2) pulmonary hypertension (14 patients—19.2%), (3) vascular tree-in-bud pattern (10 patients—13.7%), and (4) pulmonary infarction (three patients—4.1%). There were no significant associations between these signs and the CT opacity score (0.3205–0.7551, all >0.05). Furthermore, both pulmonary vascular enlargement and the vascular tree-in-bud sign were found in patients without pulmonary embolism and low CT-severity scores (13/15–86.7% and 2/15–13.3%, respectively). Conclusion Pulmonary vascular enlargement or, less commonly, vascular tree-in-bud pattern are both indirect vascular angiopathy signs on CTPA that can explain the respiratory deterioration which complicates COVID-19 in the absence of severe parenchymal involvement or acute pulmonary embolism.

scholarly journals CT pulmonary angiography in COVID-19 pneumonia: relationship between pulmonary embolism and disease severity

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Aya Yassin ◽  
Maryam Ali Abdelkader ◽  
Rehab M. Mohammed ◽  
Ahmed M. Osman
Keyword(s):  
Pulmonary Embolism ◽  
Disease Severity ◽  
Laboratory Data ◽  
Pulmonary Angiography ◽  
Significant Relation ◽  
Ct Pulmonary Angiography ◽  
Laboratory Results ◽  
Severity Of The Disease ◽  
The Relationship ◽  
D Dimer

Abstract Background Pulmonary embolism (PE) is one of the known sequels of COVID-19 infection. We aimed to assess the incidence of PE in patients with COVID-19 infection and to evaluate the relationship between the CT severity of the disease and the laboratory indicators. This was a retrospective study conducted on 96 patients with COVID-19 infection proved by positive PCR who underwent CT pulmonary angiography (CTPA) with a calculation of the CT severity of COVID-19 infection. Available patients’ complaint and laboratory data at the time of CTPA were correlated with PE presence and disease severity. Results Forty patients (41.7%) showed positive PE with the median time for the incidence of PE which was 12 days after onset of the disease. No significant correlation was found between the incidence of PE and the patients’ age, sex, laboratory results, and the CT severity of COVID-19. A statistically significant relation was found between the incidence of PE and the patients’ desaturation, hemoptysis, and chest pain. A highly significant correlation was found between the incidence of PE and the rising in the D-dimer level as well as the progressive CT findings when compared to the previous one. Conclusion CT progression and the rising in D-dimer level are considered the most important parameters suggesting underlying PE in patients with positive COVID-19 infection which is commonly seen during the second week of infection and alert the use of CT pulmonary angiography to exclude or confirm PE. This is may help in improving the management of COVID-19 infection.

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