Diagnosis of acute pulmonary embolism in outpatients : comparison of thin-collimation multi-detector row spiral CT and planar ventilation-perfusion scintigraphy
PURPOSE: To compare multi-detector row computed tomography (CT) and ventilation-perfusion (V-P) scintigraphy in the diagnosis of acute pulmonary embolism (PE) in outpatients who were cared for in the emergency department.
MATERIALS AND METHODS: Ninety-four nonconsecutive patients, in whom acute PE was suspected, underwent thin-collimation multi-detector row CT (collimation, 4 x 1 mm; pitch, 1.25; scanning time, 0.5 second) and V-P scintigraphy. Concordance between CT and scintigraphic images was used in the diagnosis of PE. Pulmonary angiography was performed within 24 hours if interpretations of V-P and spiral CT images were inconclusive or discordant. Sensitivity and specificity values were calculated for V-P scintigrams and CT scans of the lungs. The rates of conclusive results for scintigraphy and CT were compared.
RESULTS: The sensitivity of thin-collimation multi-detector row CT and V-P scintigraphy for the detection of PE was 96% (27 of 28; CI: 82%, 99%) and 98% (65 of 66; CI: 92%, 99%), respectively. The specificity of CT and V-P scintigraphy was 86% (24 of 28; CI: 67%, 96%) and 88% (58 of 66; CI: 77%, 94%), respectively. Seven V-P scintigrams were of intermediate probability, and one spiral CT study was indeterminate. Examinations with spiral CT yielded conclusive results more often than examinations with planar V-P scintigraphy (P <.05). Five V-P scintigrams and spiral CT scans were discordant. Twelve pulmonary angiographic examinations were performed. Angiographic findings were concordant in 10 (91%) of 11 patients with conclusive CT scans in whom pulmonary angiography was attempted. CT was used to establish an alternative diagnosis in 19 (29%) of 66 patients in whom PE was excluded.
CONCLUSION: Thin-collimation multi-detector row CT is more accurate than V-P scintigraphy in the diagnosis of acute PE in outpatients. Furthermore, CT provides alternative diagnoses for patients without PE on high-quality transverse or near-isotropic reformatted images.
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Medienart: |
Artikel |
Erscheinungsjahr: |
2003 |
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Erschienen: |
2003 |
Enthalten in: |
Zur Gesamtaufnahme - volume:229 |
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Enthalten in: |
Radiology - 229(2003), 3 vom: 15. Dez., Seite 757-65 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Coche, Emmanuel [VerfasserIn] |
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Anmerkungen: |
Date Completed 12.01.2004 Date Revised 24.11.2016 published: Print ErratumIn: Radiology. 2004 Aug;232(2):627-8 Citation Status MEDLINE |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM143721941 |
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100 | 1 | |a Coche, Emmanuel |e verfasserin |4 aut | |
245 | 1 | 0 | |a Diagnosis of acute pulmonary embolism in outpatients |b comparison of thin-collimation multi-detector row spiral CT and planar ventilation-perfusion scintigraphy |
264 | 1 | |c 2003 | |
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500 | |a Date Revised 24.11.2016 | ||
500 | |a published: Print | ||
500 | |a ErratumIn: Radiology. 2004 Aug;232(2):627-8 | ||
500 | |a Citation Status MEDLINE | ||
520 | |a PURPOSE: To compare multi-detector row computed tomography (CT) and ventilation-perfusion (V-P) scintigraphy in the diagnosis of acute pulmonary embolism (PE) in outpatients who were cared for in the emergency department | ||
520 | |a MATERIALS AND METHODS: Ninety-four nonconsecutive patients, in whom acute PE was suspected, underwent thin-collimation multi-detector row CT (collimation, 4 x 1 mm; pitch, 1.25; scanning time, 0.5 second) and V-P scintigraphy. Concordance between CT and scintigraphic images was used in the diagnosis of PE. Pulmonary angiography was performed within 24 hours if interpretations of V-P and spiral CT images were inconclusive or discordant. Sensitivity and specificity values were calculated for V-P scintigrams and CT scans of the lungs. The rates of conclusive results for scintigraphy and CT were compared | ||
520 | |a RESULTS: The sensitivity of thin-collimation multi-detector row CT and V-P scintigraphy for the detection of PE was 96% (27 of 28; CI: 82%, 99%) and 98% (65 of 66; CI: 92%, 99%), respectively. The specificity of CT and V-P scintigraphy was 86% (24 of 28; CI: 67%, 96%) and 88% (58 of 66; CI: 77%, 94%), respectively. Seven V-P scintigrams were of intermediate probability, and one spiral CT study was indeterminate. Examinations with spiral CT yielded conclusive results more often than examinations with planar V-P scintigraphy (P <.05). Five V-P scintigrams and spiral CT scans were discordant. Twelve pulmonary angiographic examinations were performed. Angiographic findings were concordant in 10 (91%) of 11 patients with conclusive CT scans in whom pulmonary angiography was attempted. CT was used to establish an alternative diagnosis in 19 (29%) of 66 patients in whom PE was excluded | ||
520 | |a CONCLUSION: Thin-collimation multi-detector row CT is more accurate than V-P scintigraphy in the diagnosis of acute PE in outpatients. Furthermore, CT provides alternative diagnoses for patients without PE on high-quality transverse or near-isotropic reformatted images | ||
650 | 4 | |a Comparative Study | |
650 | 4 | |a Journal Article | |
700 | 1 | |a Verschuren, Franck |e verfasserin |4 aut | |
700 | 1 | |a Keyeux, André |e verfasserin |4 aut | |
700 | 1 | |a Goffette, Pierre |e verfasserin |4 aut | |
700 | 1 | |a Goncette, Louis |e verfasserin |4 aut | |
700 | 1 | |a Hainaut, Philippe |e verfasserin |4 aut | |
700 | 1 | |a Hammer, Frank |e verfasserin |4 aut | |
700 | 1 | |a Lavenne, Edith |e verfasserin |4 aut | |
700 | 1 | |a Zech, Francis |e verfasserin |4 aut | |
700 | 1 | |a Meert, Philippe |e verfasserin |4 aut | |
700 | 1 | |a Reynaert, Marc S |e verfasserin |4 aut | |
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