The Role of Spiral Volumetric Computed Tomography in the Diagnosis of Pulmonary Embolism

Abstract

To evaluate the evidence for the use of spiral volumetric computed tomography (SVCT) in the diagnosis of acute pulmonary embolism (PE), the 11 English-language studies published through July 1998 that compared SVCT with a reference standard for PE were systematically reviewed. Among the reviewed studies, methodological problems were common. Only 5 of these studies fulfilled 5 of 11 basic standards addressing important issues in diagnostic test research. The reported sensitivities of SVCT compared with pulmonary angiography varied widely (64%-93%), which was likely the result of differences in study populations. Spiral volumetric computed tomography may be relatively sensitive and specific for diagnosing central pulmonary artery PEs, but it is insensitive for diagnosing subsegmental clots. Spiral volumetric computed tomography may have a role as a "rule-in" test for large central emboli, but additional research is required to establish its place in clinical practice.

Impact of reliance on CT pulmonary angiography on diagnosis of pulmonary embolism: A Bayesian analysis

“…Initial studies of CTPA supported this appearance of diagnostic certainty, reporting sen-sitivity and specificity of greater than 90%, 3,4 but several subsequent studies have failed to reproduce these results. [5][6][7] Newer multidetector CT scans are believed to be more accurate than earlier singledetector CT, 8 but true estimates of CTPA test characteristics will not be known until publication of the forthcoming PIOPED II study. 9 Even without these data, CT-based diagnostic algorithms have already appeared.…”

Effect of age on the assessment of clinical probability of pulmonary embolism by prediction rules

“…PE can mimic a vast number of cardiopulmonary diseases, particularly in elderly patients in whom it remains a diagnostic challenge. Contemporary diagnosis of PE rests on sequential diagnostic strategies usually including clinical probability, D-dimer test, compression ultrasonography (US) of the lower limbs, ventilation-perfusion lung scan or helical computed tomography (CT) and angiography [4][5][6].…”

“…Potassium homeostasis is partly regulated by kidney and controlled by renin-angiotensin-aldosterone system. Urinary potassium excretion is a function of potassium concentration in the lumen of the cortical collecting duct (CCD) times the urine flow rate [6]. Determining the transtubular potassium concentration gradient (TTKG) is a novel clinical approach to estimate the urinary potassium excretion.…”

Successful Surgical Pulmonary Embolectomy for Massive Pulmonary Embolism with Multiple Thrombogenic Risk Factors: A Case Report

“…Previous studies have shown that PE has been frequently overlooked, and therefore, the mortality rate in such cases is significantly increased (3,4) . One of the most important diagnostic methods in suspected cases of PE is computed tomography (CT) scans of the pulmonary artery (5,6) …”