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.

Errataetall:

ErratumIn: Radiology. 2004 Aug;232(2):627-8

Medienart:

Artikel

Erscheinungsjahr:

2003

Erschienen:

2003

Enthalten in:

Zur Gesamtaufnahme - volume:229

Enthalten in:

Radiology - 229(2003), 3 vom: 15. Dez., Seite 757-65

Sprache:

Englisch

Beteiligte Personen:

Coche, Emmanuel [VerfasserIn]
Verschuren, Franck [VerfasserIn]
Keyeux, André [VerfasserIn]
Goffette, Pierre [VerfasserIn]
Goncette, Louis [VerfasserIn]
Hainaut, Philippe [VerfasserIn]
Hammer, Frank [VerfasserIn]
Lavenne, Edith [VerfasserIn]
Zech, Francis [VerfasserIn]
Meert, Philippe [VerfasserIn]
Reynaert, Marc S [VerfasserIn]

Themen:

Comparative Study
Journal Article

Anmerkungen:

Date Completed 12.01.2004

Date Revised 24.11.2016

published: Print

ErratumIn: Radiology. 2004 Aug;232(2):627-8

Citation Status MEDLINE

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM143721941