HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Erratum (v213,p930) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bergin, C. J. Articles by Fedullo, P. F. Search for Related Content PubMed PubMed Citation Articles by Bergin, C. J. Articles by Fedullo, P. F.

Identifying the Cause of Unilateral Hypoperfusion in Patients Suspected to Have Chronic Pulmonary Thromboembolism: Diagnostic Accuracy of Helical CT and Conventional Angiography¹

¹ From the Departments of Radiology (C.J.B., J.P.H., M.A.B.) and Medicine (R.N.C., P.F.F.), University of California, San Diego, 200 W. Arbor Dr, San Diego, CA 92103. Received March 5, 1998; revision requested June 18; revision received February 15, 1999; accepted June 8. Address reprint requests to M.B.

PURPOSE: To determine the prevalence of unilateral hypoperfusion in patients suspected to have chronic thromboembolism (CTE), to identify the most common cause of hypoperfusion, and to compare the accuracy of helical computed tomographic (CT) angiography with that of conventional angiography in helping to determine the cause.

MATERIALS AND METHODS: Radionuclide lung scan reports showed asymmetric hypoperfusion in 47 of 410 consecutive patients referred because of suspected CTE. Twenty-seven patients had unilateral or predominantly unilateral perfusion abnormalities. Each pulmonary angiogram and CT angiogram in these patients was interpreted independently by two readers blinded to clinical information and surgical outcome. Surgical confirmation of the diagnosis was available in 39 of the 47 patients with asymmetric hypoperfusion.

RESULTS: Unilateral (n = 11) or predominantly unilateral hypoperfusion (n = 16) was found in 6.6% (27 of 410 patients) of patients referred, and CTE was the most common cause. The accuracies of CT angiogram readers (reader 1, 83%; reader 2, 89%) were greater than those of conventional angiogram readers (reader 1, 73%; reader 2, 65%) for distinguishing CTE from other causes.

CONCLUSION: Unilateral hypoperfusion occurred in 6.6% of our study population, most frequently because of CTE. CT angiography is an excellent diagnostic alternative to conventional angiography for distinguishing patients with CTE from those with other causes.

Index terms: Embolectomy • Embolism, pulmonary, 60.72 • Lung, abnormalities, 60.721, 67.272 • Lung, angiography, 60.12116, 60.1241 • Lung, CT, 60.1211, 60.12115, 60.12116 • Lung, radionuclide studies, 60.12174 • Mediastinum, diseases, 67.272

This article has been cited by other articles:

				S. Takaoka, J. L. Faul, and R. Doyle Current Therapies for Pulmonary Arterial Hypertension Seminars in Cardiothoracic and Vascular Anesthesia, June 1, 2007; 11(2): 137 - 148. [Abstract] [PDF]

				M. Remy-Jardin, A. Duhamel, V. Deken, N. Bouaziz, P. Dumont, and J. Remy Systemic Collateral Supply in Patients with Chronic Thromboembolic and Primary Pulmonary Hypertension: Assessment with Multi-Detector Row Helical CT Angiography Radiology, April 1, 2005; 235(1): 274 - 281. [Abstract] [Full Text] [PDF]

				M. McGoon, D. Gutterman, V. Steen, R. Barst, D. C. McCrory, T. A. Fortin, and J. E. Loyd Screening, Early Detection, and Diagnosis of Pulmonary Arterial Hypertension: ACCP Evidence-Based Clinical Practice Guidelines Chest, July 1, 2004; 126(1_suppl): 14S - 34S. [Abstract] [Full Text] [PDF]

				R. L. Doyle, D. McCrory, R. N. Channick, G. Simonneau, and J. Conte Surgical Treatments/Interventions for Pulmonary Arterial Hypertension: ACCP Evidence-Based Clinical Practice Guidelines Chest, July 1, 2004; 126(1_suppl): 63S - 71S. [Abstract] [Full Text] [PDF]

				P. F. Fedullo, W. R. Auger, K. M. Kerr, and L. J. Rubin Chronic Thromboembolic Pulmonary Hypertension N. Engl. J. Med., November 15, 2001; 345(20): 1465 - 1472. [Full Text] [PDF]

				A. A. Frazier, J. R. Galvin, T. J. Franks, and M. L. Rosado-de-Christenson From the Archives of the AFIP : Pulmonary Vasculature: Hypertension and Infarction (CME available in print version and on RSNA Link) RadioGraphics, March 1, 2000; 20(2): 491 - 524. [Abstract] [Full Text] [PDF]