| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
1
Department of Radiology, Unité d'Imagerie
Thoracique et Cardiovasculaire, CHU Bordeaux,
Hôpital Cardiologique
Haut-Lévêque,
Ave. de Magellan, 33604 Pessac, France.
2
Department of Nuclear Medicine, CHU Bordeaux,
Hôpital
Haut-Lévêque,
33604 Pessac, France.
3
Department of Cardiology, CHU Bordeaux, Hôpital
Haut-Lévêque,
33604 Pessac, France.
4
Department of Pneumology, CHU Bordeaux, Hôpital
Haut-Lévêque,
33604 Pessac, France.
5
Laboratoire de physiologie cellulaire respiratoire, INSERM E 9937,
Université Victor
Ségalen, Bordeaux 2, France.
OBJECTIVE. We compared helical CT angiography and ventilation—perfusion radionuclide lung scanning as initial tests in the diagnosis of acute pulmonary embolism.
SUBJECTS AND METHODS. Two hundred sixteen consecutive patients who were clinically suspected of having acute pulmonary embolism underwent helical CT angiography, ventilation—perfusion radionuclide lung scanning, and Doppler sonography of the veins of the legs. On the basis of concordance of the results for ventilation—perfusion radionuclide lung scanning and helical CT angiography and on the degree of clinical suspicion, certain patients underwent pulmonary angiography. Patients without pulmonary embolism at initial evaluation in whom no treatment was instituted were followed up for at least 3 months to determine the potential recurrence of thromboembolic disease.
RESULTS. Of the 216 patients, 37 (17%) were excluded because of
insufficient data to assess the initial event. Final diagnosis for the 179
remaining patients was pulmonary embolism in 68 (37.9%) and no pulmonary
embolism in 111 (62.0%), based on pulmonary angiography in 23 patients (12.8%)
and concordant imaging findings and outcome in the remaining patients.
Statistically significant differences (p < 0.05) were found
between sensitivity, specificity, positive predictive value, and negative
predictive value for helical CT angiography and ventilation—perfusion
radionuclide lung scanning (94.1% versus 80.8%; 93.6% versus 73.8%; 95.5%
versus 82%; and 96.2% versus 75.9%, respectively). Interobserver agreement was
excellent for helical CT angiography (
= 0.72) and moderate for
ventilation—perfusion radionuclide lung scanning ( = 0.22).
CONCLUSION. Helical CT angiography could replace ventilation—perfusion radionuclide lung scanning as the initial test for screening patients who are clinically suspected of having pulmonary embolism.
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
|
|
 |
|
  M. M. Costantino, G. Randall, M. Gosselin, M. Brandt, K. Spinning, and C. D. Vegas CT Angiography in the Evaluation of Acute Pulmonary Embolus Am. J. Roentgenol., August 1, 2008; 191(2): 471 - 474. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. M. Heyer, P. S. Mohr, S. P. Lemburg, S. A. Peters, and V. Nicolas Image Quality and Radiation Exposure at Pulmonary CT Angiography with 100- or 120-kVp Protocol: Prospective Randomized Study Radiology, November 1, 2007; 245(2): 577 - 583. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Burrill, Z. Dabbagh, F. Gollub, and M. Hamady Multidetector computed tomographic angiography of the cardiovascular system Postgrad. Med. J., November 1, 2007; 83(985): 698 - 704. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. H. McCollough, B. A. Schueler, T. D. Atwell, N. N. Braun, D. M. Regner, D. L. Brown, and A. J. LeRoy Radiation Exposure and Pregnancy: When Should We Be Concerned? RadioGraphics, July 1, 2007; 27(4): 909 - 917. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Ritchie, S. McGurk, C. McCreath, C. Graham, and J. T Murchison Prospective evaluation of unsuspected pulmonary embolism on contrast enhanced multidetector CT (MDCT) scanning Thorax, June 1, 2007; 62(6): 536 - 540. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Kluge, W. Luboldt, and G. Bachmann Acute pulmonary embolism to the subsegmental level: diagnostic accuracy of three MRI techniques compared with 16-MDCT. Am. J. Roentgenol., July 1, 2006; 187(1): W7 - 14. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Reinartz, H.-J. Kaiser, J. E. Wildberger, C. Gordji, B. Nowak, and U. Buell SPECT Imaging in the Diagnosis of Pulmonary Embolism: Automated Detection of Match and Mismatch Defects by Means of Image-Processing Techniques J. Nucl. Med., June 1, 2006; 47(6): 968 - 973. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. K. Yousefzadeh, M. B. Ward, and C. Reft Internal Barium Shielding to Minimize Fetal Irradiation in Spiral Chest CT: A Phantom Simulation Experiment. Radiology, June 1, 2006; 239(3): 751 - 758. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S Matthews Imaging pulmonary embolism in pregnancy: what is the most appropriate imaging protocol? Br. J. Radiol., May 1, 2006; 79(941): 441 - 444. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. E. Jones and C. Wittram The Indeterminate CT Pulmonary Angiogram: Imaging Characteristics and Patient Clinical Outcome Radiology, October 1, 2005; 237(1): 329 - 337. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Patel and E. A. Kazerooni Helical CT for the Evaluation of Acute Pulmonary Embolism Am. J. Roentgenol., July 1, 2005; 185(1): 135 - 149. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Quiroz, N. Kucher, K. H. Zou, F. Kipfmueller, P. Costello, S. Z. Goldhaber, and U. J. Schoepf Clinical Validity of a Negative Computed Tomography Scan in Patients With Suspected Pulmonary Embolism: A Systematic Review JAMA, April 27, 2005; 293(16): 2012 - 2017. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Prologo, R. C. Gilkeson, M. Diaz, and M. Cummings The Effect of Single-Detector CT Versus MDCT on Clinical Outcomes in Patients with Suspected Acute Pulmonary Embolism and Negative Results on CT Pulmonary Angiography Am. J. Roentgenol., April 1, 2005; 184(4): 1231 - 1235. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. A. Eyer, L. R. Goodman, and L. Washington Clinicians' Response to Radiologists' Reports of Isolated Subsegmental Pulmonary Embolism or Inconclusive Interpretation of Pulmonary Embolism Using MDCT Am. J. Roentgenol., February 1, 2005; 184(2): 623 - 628. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Cauley and P. Wright Iliac Vein Compression and Pulmonary Embolism in a Long Distance Runner: Computed Tomography and Magnetic Resonance Imaging: A Case Report Angiology, January 1, 2005; 56(1): 87 - 91. [Abstract] [PDF]
|
|
|
|
 |
|
 L. K. Moores, W. L. Jackson Jr., A. F. Shorr, and J. L. Jackson Meta-Analysis: Outcomes in Patients with Suspected Pulmonary Embolism Managed with Computed Tomographic Pulmonary Angiography Ann Intern Med, December 7, 2004; 141(11): 866 - 874. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Prologo, R. C. Gilkeson, M. Diaz, and J. Asaad CT Pulmonary Angiography: A Comparative Analysis of the Utilization Patterns in Emergency Department and Hospitalized Patients Between 1998 and 2003 Am. J. Roentgenol., October 1, 2004; 183(4): 1093 - 1096. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Reinartz, J. E. Wildberger, W. Schaefer, B. Nowak, A. H. Mahnken, and U. Buell Tomographic Imaging in the Diagnosis of Pulmonary Embolism: A Comparison Between V/Q Lung Scintigraphy in SPECT Technique and Multislice Spiral CT J. Nucl. Med., September 1, 2004; 45(9): 1501 - 1508. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 U. J. Schoepf, S. Z. Goldhaber, and P. Costello Spiral Computed Tomography for Acute Pulmonary Embolism Circulation, May 11, 2004; 109(18): 2160 - 2167. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. P. Kanne and T. A. Lalani Role of Computed Tomography and Magnetic Resonance Imaging for Deep Venous Thrombosis and Pulmonary Embolism Circulation, March 30, 2004; 109(12_suppl_1): I-15 - I-21. [Abstract] [Full Text]
|
|
|
|
|
|
A. S. Wu, J. A. Pezzullo, J. J. Cronan, D. D. Hou, and W. W. Mayo-Smith CT Pulmonary Angiography: Quantification of Pulmonary Embolus as a Predictor of Patient Outcome--Initial Experience Radiology, March 1, 2004; 230(3): 831 - 835. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. J. Schoepf and P. Costello CT Angiography for Diagnosis of Pulmonary Embolism: State of the Art Radiology, February 1, 2004; 230(2): 329 - 337. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. A. Froehling, P. L. Elkin, S. J. Swensen, J. A. Heit, V. S. Pankratz, and J. H. Ryu Sensitivity and Specificity of the Semiquantitative Latex Agglutination D-Dimer Assay for the Diagnosis of Acute Pulmonary Embolism as Defined by Computed Tomographic Angiography Mayo Clin. Proc., February 1, 2004; 79(2): 164 - 168. [Abstract] [PDF]
|
|
|
|
|
|
British Thoracic Society guidelines for the management of suspected acute pulmonary embolism Thorax, June 1, 2003; 58(6): 470 - 483. [Full Text] [PDF]
|
|
|
|
 |
|
 S. D. Nathan, S. D. Barnett, B. A. Urban, C. Nowalk, B. R. Moran, and N. Burton Pulmonary Embolism in Idiopathic Pulmonary Fibrosis Transplant Recipients Chest, May 1, 2003; 123(5): 1758 - 1763. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Patel, E. A. Kazerooni, and P. N. Cascade Pulmonary Embolism: Optimization of Small Pulmonary Artery Visualization at Multi-Detector Row CT Radiology, May 1, 2003; 227(2): 455 - 460. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Bourriot, T. Couffinhal, V. Bernard, M. Montaudon, J. Bonnet, and F. Laurent Clinical Outcome After a Negative Spiral CT Pulmonary Angiographic Finding in an Inpatient Population From Cardiology and Pneumology Wards Chest, February 1, 2003; 123(2): 359 - 365. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. S. Ginsberg, J. Oh, A. Welber, and D. M. Panicek Clinical Usefulness of Imaging Performed After CT Angiography That Was Negative for Pulmonary Embolus in a High-Risk Oncologic Population Am. J. Roentgenol., November 1, 2002; 179(5): 1205 - 1208. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. C. Gaba, R. C. Carlos, W. J. Weadock, G. P. Reddy, M. B. Sneider, and P. N. Cascade Cardiovascular MR Imaging: Technique Optimization and Detection of Disease in Clinical Practice RadioGraphics, November 1, 2002; 22(6): e6 - e6. [Abstract] [Full Text]
|
|
|
|
|
|
H. T. Winer-Muram, J. M. Boone, H. L. Brown, S. G. Jennings, W. C. Mabie, and G. T. Lombardo Pulmonary Embolism in Pregnant Patients: Fetal Radiation Dose with Helical CT Radiology, August 1, 2002; 224(2): 487 - 492. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N.L. Muller Computed tomography and magnetic resonance imaging: past, present and future Eur. Respir. J., February 1, 2002; 19(35_suppl): 3S - 12s. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Pistolesi and M. Miniati Imaging techniques in treatment algorithms of pulmonary embolism Eur. Respir. J., February 1, 2002; 19(35_suppl): 28S - 39s. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. F. Rogers Scientific Objectivity: Differentiating Gimmicks from Breakthroughs Am. J. Roentgenol., April 1, 2000; 174(4): 899 - 899. [Full Text]
|
|
|
|
|
|
V. Raptopoulos and P. M. Boiselle Multi-Detector Row Spiral CT Pulmonary Angiography: Comparison with Single-Detector Row Spiral CT Radiology, December 1, 2001; 221(3): 606 - 613. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
