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Unenhanced multidetector computed tomography findings in acute central pulmonary embolism
- Source :
- BMC Medical Imaging, Vol 19, Iss 1, Pp 1-8 (2019), BMC Medical Imaging
- Publication Year :
- 2019
- Publisher :
- BMC, 2019.
-
Abstract
- Background Computed tomography pulmonary angiography (CTPA) is the gold standard for the diagnosis of pulmonary embolism (PE). However, contrast is contraindicated in some patients. The purpose of this study was to determine the diagnostic accuracy of unenhanced multidetector CT (MDCT) for diagnosis of central PE using CTPA as the gold standard. Methods The records of patients with suspected PE seen between 2010 and 2013 were retrospectively reviewed. Inclusion criteria were an acute, central PE confirmed by CTPA and non-enhanced MDCT before contrast injection. Patients with a PE ruled out by CTPA served as a control group. MDCT findings studied were high-attenuation emboli in pulmonary artery (PA), main PA dilatation > 33.2 mm, and peripheral wedge-shaped consolidation. Receiver operating characteristic (ROC) analysis was used to determine the sensitivity and specificity of unenhanced MDCT to detect PE. Wells score of all patients were calculated using data extracted from medical records prior to imaging analysis. Results Thirty-two patients with a PE confirmed by CTPA and 32 with a PE ruled out by CTPA were included. Among the three main MDCT findings, high-attenuation emboli in the PA showed best diagnostic performance (Sensitivity 72.9%; Specificity 100%), followed by main PA dilatation > 33.2 mm (sensitivity 46.9%; specificity 90.6%), and peripheral wedge-shaped consolidation (sensitivity 43.8%; specificity 78.1%). Given any one or more positive findings on unenhanced MDCT, the sensitivity was 96.9% and specificity was 71.9% for a diagnosis of PE in patients. The area under the curve (AUC) of a composite measure of unenhanced MDCT findings (0.909) was significantly higher than that of the Wells score (0.688), indicating unenhanced MDCT was reliable for detecting PE than Wells score. Conclusions Unenhanced MDCT is an alternative for the diagnosis of acute central PE when CTPA is not available.
- Subjects :
- Male
lcsh:Medical technology
Computed Tomography Angiography
Contrast Media
Pulmonary Artery
Sensitivity and Specificity
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
medicine.artery
Multidetector Computed Tomography
Multidetector computed tomography
Pulmonary angiography
Humans
Medicine
Radiology, Nuclear Medicine and imaging
In patient
cardiovascular diseases
CTPA
Aged
Retrospective Studies
Aged, 80 and over
Receiver operating characteristic
business.industry
High attenuation
Area under the curve
Middle Aged
medicine.disease
Imaging analysis
Pulmonary embolism
Wedge-shaped consolidation
ROC Curve
lcsh:R855-855.5
Area Under Curve
Pulmonary artery
cardiovascular system
Radiographic Image Interpretation, Computer-Assisted
Female
Pulmonary artery dilatation
Pulmonary Embolism
business
Nuclear medicine
030217 neurology & neurosurgery
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14712342
- Volume :
- 19
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Medical Imaging
- Accession number :
- edsair.doi.dedup.....374013612db1cb6b1961db811fea5c27