Acute pulmonary embolism multimodality imaging prior to endovascular therapy

Sin, David; McLennan, Gordon; Rengier, Fabian; Haddadin, Ihab; Heresi, Gustavo A.; Bartholomew, John R.; Fink, Mary Alexander; Thompson, Dustin; Partovi, Sasan

doi:10.1007/s10554-020-01980-9

Cited by 12 publications

(13 citation statements)

References 146 publications

(205 reference statements)

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“…With technological advances in recent years, CTPA can directly show the thrombus in the pulmonary artery bed up to the segmental level (23). Although acute PE cannot be observed with the help of CTPA, which we prefer for definite and rapid diagnosis of PE in ED, it can show alternative diagnoses for the patient's clinical picture (24). In a study evaluating the detection of acute PE, when CTPA was compared with pulmonary angiography, which is the gold standard, it was observed that CTPA had 91% accuracy (25).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Auxiliary Diagnostic Methods in Pulmonary Embolism

2021

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Aim:We investigated the importance of auxiliary diagnostic methods in cases when computed tomography pulmonary angiography (CTPA) cannot be used in pulmonary embolism (PE) with a high mortality rate. Materials and Methods: Patients were selected after the exclusion criteria were applied in a sample created from a single center. A total of 86 patients included in our study were examined in terms of clinical features, auxiliary diagnostic methods, anticoagulant use, and hospitalization and discharge status according to the massive or segmental involvement of PE in CTPA. Results: The mean age of the patients was 52.29±14.14 years. According to the CTPA results, there were 46 (53.5%) patients with massive involvement and 40 (46.5%) patients with segmental involvement. While there were 38 (82.6%) patients with massive involvement whose right chambers of the heart were dilated in echocardiography (ECHO) results, there were 19 (47.5%) patients with segmental involvement. There was a statistical significance between the massive involvement of CTPA and ECHO result (p=0.001). Conclusion: ECHO may be preferred as an auxiliary radiological method in the diagnosis of PE in emergency departments (ED), especially in massive embolisms.

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Section: Discussionmentioning

confidence: 99%

Comparison of Auxiliary Diagnostic Methods in Pulmonary Embolism

2021

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“…Several studies have demonstrated the importance of imaging in establishing prompt and accurate diagnosis and in guiding the proper treatment of many life-threatening emergency conditions including cardiovascular, abdominal [15] and gastrointestinal, neurological, musculoskeletal, obstetrical, genitourinary [16] and pulmonary conditions [17] in all age groups, as well as in trauma [18,19]. Imaging is an integral and crucial part in stroke diagnosis and image-guided endovascular treatment, and AI has a role to determine the presence and extent of involvement of brain parenchyma [20,21].…”

Section: Noncommunicable Diseasesmentioning

confidence: 99%

How to improve access to medical imaging in low- and middle-income countries ?

et al. 2021

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Imaging has become key in the care pathway of communicable and non-communicable diseases. Yet, there are major shortages of imaging equipment and workforce in low-and middle-income countries (LMICs). The International Society of Radiology outlines a plan to upscale the role of imaging in the global health agenda and proposes a holistic approach for LMICs. A generic model for organising imaging services in LMICs via regional Centres of Reference is presented. The need to better exploit IT and the potential of artificial intelligence for imaging, also in the LMIC setting, is highlighted. To implement the proposed plan, involvement of professional and international organisations is considered crucial. The establishment of an International Commission on Medical Imaging under the umbrella of international organisations is suggested and collaboration with other diagnostic disciplines is encouraged to raise awareness of the importance to upscale diagnostics at large and to foster its integration into the care pathway globally.

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“…Nowadays, the diagnosis of PE is mainly based on radiomics, which has also been evaluated for the diagnosis of PI [ 18 , 19 ]. In particular, CT pulmonary angiography (CTPA) is the gold standard with high accuracy [ 20 ] and dual-energy CTPA allows the identification of perfusion defects [ 20 , 21 ]. Acute PE could cause partial or complete obstruction of pulmonary vasculature but the latter can lead to PI, which appears on CTPA as ground-glass opacity with reticular changes or wedge-shaped consolidation with its base toward the pleural surface (Hampton hump) and truncated apex toward the hilum, without air bronchogram [ 7 , 20 , 22 , 23 ].…”

Section: Possible Diagnostic Criteriamentioning

confidence: 99%

“…Moreover, diffused or localized pleural effusion and thickened vessels are other salient findings of PI at CTPA examination [ 23 ]. Moreover, complete occlusions appear tortuous and calcified [ 20 ]. It is important to consider the presence of artifacts due to breathing, which could lead to misdiagnosis [ 22 , 24 ] ( Figure 1 ).…”

Section: Possible Diagnostic Criteriamentioning

confidence: 99%

Pulmonary Embolism Presenting with Pulmonary Infarction: Update and Practical Review of Literature Data

Gagno

Padoan

D’Errico

et al. 2022

JCM

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Pulmonary infarction (PI) is a possible consequence of pulmonary embolism (PE). The real incidence of PI could be underestimated considering only non-fatal PE presentation. However, following postmortem examination, the prevalence of PI is considerably higher. This evidence suggests the necessity of proper diagnostic protocol for identifying PI. Unfortunately, PI diagnosis can sometimes be challenging, due to the overlapping of symptoms with other diseases. Nowadays, the diagnosis is mainly based on radiological evaluation, although the combination with emerging imaging techniques such as ultrasound and nuclear scanning might improve the diagnostic algorithm for PI. This review aims to summarize the available data on the prevalence of PI, the main predisposing factors for the development of PI among patients with PE, to resume the possible diagnostic tools, and finally the clinical and prognostic implications.

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Acute pulmonary embolism multimodality imaging prior to endovascular therapy

Cited by 12 publications

References 146 publications

Comparison of Auxiliary Diagnostic Methods in Pulmonary Embolism

Comparison of Auxiliary Diagnostic Methods in Pulmonary Embolism

How to improve access to medical imaging in low- and middle-income countries ?

Pulmonary Embolism Presenting with Pulmonary Infarction: Update and Practical Review of Literature Data

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