Faculty Opinions recommendation of Diagnosis of pulmonary embolism by multidetector CT alone or combined with venous ultrasonography of the leg: a randomised non-inferiority trial.

Author(s):  
Paul Stein
2007 ◽  
Vol 98 (10) ◽  
pp. 713-720 ◽  
Author(s):  
Fadi Kayali ◽  
Russell Hull ◽  
Paul Stein

SummaryThe accuracy of computed tomography (CT) imaging for the diagnosis of acute pulmonary embolism (PE) was reviewed. Single detector CT, based on pooled data, showed a sensitivity of 73% and multidetector CT, mostly 4-slice, showed a sensitivity of 83%. Respective specificities were 87% and 96%. Among patients with suspected PE evaluated with single slice CT,20% of patients found to have venous thromboembolic disease were diagnosed on the basis of a positive CT venous phase venogram. With multislice CT, 14% were diagnosed on the basis of a positive CT venogram.The positive likelihood ratio with single detector CT was 5.7 and with multidetector CT it was 19.6. Respective negative likelihood ratios were 0.31 and 0.18. Calculations of post-test probability using pretest probability and likelihood ratios according to Bayes’ theorem showed that even with multidetector CT, false positive and false negative images are not uncommon when clinical assessment is discordant with the CT interpretation. Outcome studies showed recurrent PE in only 1.7% or fewer untreated patients with negative CT pulmonary angiograms.


2011 ◽  
Vol 21 (9) ◽  
pp. 1928-1937 ◽  
Author(s):  
Christoph M. Heyer ◽  
Stefan P. Lemburg ◽  
Heiko Knoop ◽  
Tim Holland-Letz ◽  
Volkmar Nicolas ◽  
...  

The Lancet ◽  
2008 ◽  
Vol 371 (9621) ◽  
pp. 1343-1352 ◽  
Author(s):  
Marc Righini ◽  
Grégoire Le Gal ◽  
Drahomir Aujesky ◽  
Pierre-Marie Roy ◽  
Olivier Sanchez ◽  
...  

Thorax ◽  
2007 ◽  
Vol 62 (6) ◽  
pp. 536-540 ◽  
Author(s):  
G. Ritchie ◽  
S. McGurk ◽  
C. McCreath ◽  
C. Graham ◽  
J. T Murchison

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Taraneh Faghihi Langroudi ◽  
Maryam Sheikh ◽  
Mohammadreza Naderian ◽  
Morteza Sanei Taheri ◽  
Amir Ashraf-ganjouei ◽  
...  

Purpose. Pulmonary embolism (PE) is a common and potentially fatal form of venous thromboembolism. The aim of this study is to investigate the association between the pulmonary arterial obstruction index and atrial size in patients with acute pulmonary embolism. Basic Procedure. The study consisted of 86 patients with clinical symptoms of PE. Out of 86 individuals, 50 patients were diagnosed with PE and considered as the patient group. The others were considered as the control group. All patients were scanned by a multidetector CT scanner. Using the radiology workstation, an expert radiologist calculated the left atrium (LA) and right atrium (RA) areas from planimetric measurements obtained from free-hand delineation of the atrial boarders using an electronic pen. Quantitative volumetric measurements of LA and RA were obtained from original axial images. Main Findings. There were 25 males and 25 females with PE, who had a mean age of 58 years. There was not a significant difference in the positive history of diabetes mellitus, hypertension, asthma, chronic obstructive pulmonary diseases, ischemic heart disease, and smoking between patients and control group. There was a significant negative correlation between almost all LA measurements and the PAOI. RA area and volume had the highest area under the curves for recognizing larger clot burden. Principal Conclusions. A higher clot load is associated with a smaller LA size and increased RA/LA ratios, measured with CTPA. Atrial measurements are correlated with POAI, and they could be used as sensitive parameters in predicting heart failure in patients with PE.


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