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Radiology, Vol 200, 699-706, Copyright © 1996 by Radiological Society of North America
ARTICLES |
M Remy-Jardin, J Remy, F Deschildre, D Artaud, JP Beregi, C Hossein-Foucher, X Marchandise and A Duhamel
Department of Radiology, Hopital Calmette, Lille, France.
PURPOSE: To evaluate the accuracy of spiral computed tomography (CT) in the noninvasive diagnosis of pulmonary embolism (PE). MATERIALS AND METHODS: A prospective study was performed in 75 patients who were evaluated with spiral CT and pulmonary angiography of each lung to detect central PE; 25 of the patients also underwent ventilation- perfusion (V-P) scanning. RESULTS: Spiral CT scans were technically suboptimal in three patients. CT and angiographic findings were negative for PE in 25 patients; one patient had false-negative CT findings. Findings from both studies were positive in 39 patients. CT findings of 188 central emboli corresponded exactly to those of angiography. Ten emboli were depicted only on CT scans, whereas seven emboli were identified only on angiograms because of inadequate depiction of the pulmonary arteries in the plane of the CT scans (n = 5) or because of misinterpretation of CT findings (n = 2). The prospective sensitivity of CT was 91%, the specificity was 78%, the positive predictive value was 100%, and the negative predictive value was 89%. Technical failures (n = 3) and inconclusive CT findings (n = 7) were the major limitations of spiral CT. Spiral CT enabled accurate classification of PE in 16 patients with indeterminate (n = 7) and low (n = 9) probability of PE on V-P scans. CT demonstrated central PE in two patients with normal V-P scans. CONCLUSION: Spiral CT can reliably depict central PE and may be introduced into the classic diagnostic algorithms.
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||||
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||||
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||||
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||||
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||||
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||||
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||||
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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] |
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C.J. Herold Spiral computed tomography of pulmonary embolism Eur. Respir. J., February 1, 2002; 19(35_suppl): 13S - 21s. [Abstract] [Full Text] [PDF] |
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S P G Padley Lung scintigraphy vs spiral CT in the assessment of pulmonary emboli Br. J. Radiol., January 1, 2002; 75(889): 5 - 8. [Full Text] [PDF] |
||||
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S M Thomas The current role of catheter angiography Imaging, December 15, 2001; 13(5): 366 - 375. [Abstract] [Full Text] [PDF] |
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A. Reissig, J.-P. Heyne, and C. Kroegel Sonography of Lung and Pleura in Pulmonary Embolism : Sonomorphologic Characterization and Comparison With Spiral CT Scanning Chest, December 1, 2001; 120(6): 1977 - 1983. [Abstract] [Full Text] [PDF] |
||||
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E. A. Kazerooni Population and Sample Am. J. Roentgenol., November 1, 2001; 177(5): 993 - 999. [Full Text] [PDF] |
||||
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A.B. Donkers-van Rossum Diagnostic strategies for suspected pulmonary embolism Eur. Respir. J., September 1, 2001; 18(3): 589 - 597. [Abstract] [Full Text] [PDF] |
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