Unsuspected pulmonary embolism: prospective detection on routine helical CT scans.

Gosselin, Mark V.; Rubin, Geoffrey D.; Leung, Ann N.; Huang, Judy; Rizk, Norman W.

doi:10.1148/radiology.208.1.9646815

Cited by 152 publications

(79 citation statements)

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“…Up to 1.5% of patients undergoing routine chest CT are found to have an unsuspected PE [15,16]. This incidence increases to 4% in inpatients and 5% in patients with neoplastic disease [16,17]. Wittram [18] suggested that the mean attenuation values for acute and chronic emboli were 78 HU and 87 HU, respectively.…”

Section: Discussionmentioning

confidence: 99%

Multidetector CT imaging of pleura: comparison of two contrast infusion protocols

Raj¹,

Kirke²,

Bankart³

et al. 2011

BJR

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Objectives: Imaging of the pleura by multidetector CT (MDCT) can be challenging. There is no clear evidence or guidelines on contrast infusion parameters for imaging pleura. We compared two contrast protocols for assessing pleural pathology on MDCT.Methods: This was a prospective study in which consecutive patients with MDCT for suspected pleural disease on chest radiograph were randomised into two groups. The first group received 150 ml of intravenous contrast at a rate of 2.5 ml s -1 and the second group received 100 ml at 2 ml s -1. Images were acquired after a 60 s delay. Hounsfield units of the pleura, thoracic aorta, main pulmonary artery, portal vein and superior mesenteric artery were measured and analysed by two independent readers. Results: 40 patients (20 in each group) who had pleural enhancement on MDCT were included for final analysis. The mean pleural enhancement value was 83 HU (Group A) vs 59 HU (Group B) (p50.0004). The mean aortic enhancement was 241 HU (A) vs 141 HU (B) (p,0.0001); main pulmonary artery enhancement was 208 HU (A) vs 139 HU (B) (p,0.0002); portal venous enhancement was 169 HU (A) vs 115 HU (B) (p,0.0001); and the superior mesenteric artery enhancement was 215 HU (A) vs 128 HU (B) (p,0.0001). Conclusion: Enhancement of the pleura and major vessels was significantly higher in the group receiving more contrast at a greater infusion rate. This technique of a single scan through the entire pleural surface with a delayed acquisition is promising. When pleural disease is suspected, contrast infusion protocols should be modified to achieve the best results and clinicians should be encouraged to specifically request a ''pleural CT''.

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Section: Discussionmentioning

confidence: 99%

Multidetector CT imaging of pleura: comparison of two contrast infusion protocols

Raj¹,

Kirke²,

Bankart³

et al. 2011

BJR

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“…Electron-beam CT and spiral CT have proved reliable in depicting clot (31,32) and the pulmonary vasculature (33), even in patients in whom thromboembolism is not clinically suspected (34,35). In 1997, Mayo et al (36) demonstrated that CT rivaled scintigraphy and Remy-Jardin et al (37) showed that it rivaled conventional angiography in detecting pulmonary thromboembolism.…”

Section: Clinical Applications Thoracic Vasculaturementioning

confidence: 99%

Multi–Detector Row CT of Thoracic Disease with Emphasis on 3D Volume Rendering and CT Angiography

Lawler¹,

Fishman²

2001

RadioGraphics

159

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Multi-detector row computed tomography (CT) with three-dimensional (3D) volume rendering provides a unique perspective on thoracic anatomy and disease. Multi-detector row CT allows shorter acquisition times, greater coverage, and superior image resolution. Three-dimensional volume rendering now permits real-time, interactive modification of relative pixel attenuation in an infinite number of planes and projections. In vascular imaging, this technique provides image quality that equals or surpasses that of conventional angiography. Its use has expanded to aid in diagnosis and surgical planning, often obviating conventional or digital angiography and reducing costs. It is reliable in depicting clot and the pulmonary vasculature and may also be used to evaluate thoracic venous anomalies (eg, pulmonary arteriovenous malformations) and to plan therapy. Airway imaging with multi-detector row CT with 3D volume rendering is particularly useful in the planning and follow-up of stent placement. In diffuse lung disease, this technique can increase nodule detection and help differentiate between small nodules and vessels. It is also helpful in imaging the musculoskeletal system and the thoracic cage. Multi-detector row CT with 3D volume rendering has enhanced the conventional roles of thoracic CT and challenged the supremacy of other imaging modalities. It will likely play a leading role in future radiologic research and practice.Abbreviations: MIP ϭ maximum intensity projection, 3D ϭ three-dimensional, 2D ϭ two-dimensional

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“…Numerosi studi radiologici, sia prospettici sia retrospettivi, hanno valutato la prevalenza di embolia polmonare non sospettata e rilevata incidentalmente in indagini TC di routine [5][6][7]. L'embolia come reperto incidentale è stata riscontrata nell'1,5%-3,4% dei casi, soprattutto nei soggetti di età oltre 60 anni, con una prevalenza ospedaliera dal 4% al 5% e prevalenza ambulatoriale dallo 0,6% al 2,2%.…”

Section: La Prevalenza DI Embolia Polmonare (Ep) Nelle Angio-tc Polmounclassified

“…A number of radiological studies, both prospective and retrospective, assessed the prevalence of pulmonary embolism, previously unsuspected and incidentally detected on routine spiral CT exams [5][6][7]. Unsuspected embolism was found in 1.5%-3.4% of the cases, mainly in subjects over 60 years of age, with an inpatient prevalence of 4% to 5% and an outpatient prevalence of 0.6% to 2.2%.…”

Section: La Prevalenza DI Embolia Polmonare (Ep) Nelle Angio-tc Polmomentioning

confidence: 99%

Subsegmental pulmonary embolism: is the emperor still naked?

et al. 2013

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Unsuspected pulmonary embolism: prospective detection on routine helical CT scans.

Abstract: The prevalence of unsuspected PE was highest among inpatients with cancer. A directed, workstation-based search can improve the PE detection rate over that with hard-copy review.

Cited by 152 publications

References 0 publications

Multidetector CT imaging of pleura: comparison of two contrast infusion protocols

Multidetector CT imaging of pleura: comparison of two contrast infusion protocols

Multi–Detector Row CT of Thoracic Disease with Emphasis on 3D Volume Rendering and CT Angiography

Subsegmental pulmonary embolism: is the emperor still naked?

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