Computed tomography pulmonary angiogram diagnosis of pulmonary embolism

R. M. Subramaniam, D. Blair, K. Gilbert, J. Sleigh, N. Karalus

Research output: Contribution to journalReview article

6 Scopus citations

Abstract

Over the last decade, contrast-enhanced spiral CT has been established as a non-invasive alternative to catheter angiography and is now regarded as the first-line imaging investigation for the diagnosis of pulmonary embolism (PE). The reported sensitivities for the diagnosis of PE of spiral CT vary from 45 to 100% and the specificities vary from 78 to 100%. Prospective outcome studies have shown a high negative predictive value for a single-detector spiral CT for PE. Patients' outcomes were not adversely affected in these studies when anticoagulation was withheld after a negative CT pulmonary angiogram. The main limitation of single-detector spiral CT has been its limited ability to detect isolated subsegmental PE. However, multidetector spiral CT allows evaluation of pulmonary vessels down to sixth-order branches and significantly increases the rate of detection of PE in segmental and subsegmental levels. The interobserver correlations for diagnosis of subsegmental PE with multidetector spiral CT exceed the reproducibility of selective pulmonary angiography. If appropriate equipment is available (multidetector CT), then CT pulmonary angiogram is safe to be used as the first-line imaging investigation for the diagnosis of PE.

Original languageEnglish (US)
Pages (from-to)193-200
Number of pages8
JournalAustralasian Radiology
Volume50
Issue number3
DOIs
StatePublished - Jun 1 2006

Keywords

  • Diagnosis
  • Pulmonary embolism
  • Spiral computed tomography angiogram

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Subramaniam, R. M., Blair, D., Gilbert, K., Sleigh, J., & Karalus, N. (2006). Computed tomography pulmonary angiogram diagnosis of pulmonary embolism. Australasian Radiology, 50(3), 193-200. https://doi.org/10.1111/j.1440-1673.2006.01561.x