The analysis of non-thromboembolic findings encountered in multidetector computed tomography pulmonary angiography studies in patients with suspected pulmonary embolism
Bilal Battal1, Bülent Karaman1, Seyfettin Gümüş2, Veysel Akgün3, Uğur Bozlar1, Mustafa Taşar1
1Gulhane Military Medical School, Department Of Radiology, Etlik, Ankara, Turkey
2Gulhane Military Medical School, Department Of Chest Disease, Etlik, Ankara, Turkey
3Golcuk Military Hospital, Department Of Radiology, Golcuk, Kocaeli, Turkey
Keywords: Pulmonary embolism, MDCT, pulmonary angiography, infiltration, atelectasis
Objective: The aims of this study were to determine the frequency of pulmonary embolism in patients evaluated with multidetector computed tomography (MDCT) pulmonary angiography for suspected pulmonary embolism, and to analyze other MDCT findings that contributed to the diagnosis and treatment in these patients.
Materials and Methods: Approval for this retrospective study was obtained from the local ethical committee of our hospital. A total of 223 patients (128 male, 95 female, mean age: 58.6) who underwent MDCT pulmonary angiography for suspected pulmonary embolism between December 2009 - November 2010 were included in the study. Pulmonary CT angiography studies were performed with 64-detector MDCT device using 70-100 ml of non-ionic iodinated contrast material. CT images of all patients were reviewed retrospectively. All findings that may be associated with symptomatology or detected incidentally in patients were recorded.
Results: 11.7% of the patients (26/223) had pulmonary embolism. In 154 of the 197 (78.2%) patients who had no pulmonary embolism, imaging findings related the symptoms and clinical findings (62.5%) or unrelated –incidental findings (37.5%) were detected in lungs mediastinal structures, chest wall or upper abdominal organs. The most common imaging findings were lung infiltration-consolidation (15.1%), atelectasis (13.5%) and pleural effusion (13.1%). There were no findings at MDCT pulmonary angiography in forty-three (21.8%) patients.
Conclusion: While majority of the patients evaluated with MDCT pulmonary angiography for suspected pulmonary embolism had no pulmonary embolism, various data that explains symptoms and clinical findings or that is unrelated with the clinical situation can be determined on MDCT pulmonary angiography images in these patients. Therefore, careful examination of the structures other than pulmonary vasculatures in the field of view and the correct interpretation of these findings in MDCT pulmonary angiography images are also important for accurate diagnosis and management of the patients.