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'Pulmonary Vein Sign' for Pulmonary Embolism Diagnosis in Computed Tomography Angiography
'Pulmonary Vein Sign' for Pulmonary Embolism Diagnosis in Computed Tomography Angiography
- Source :
- Repositório Institucional PUCRS, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), instacron:PUC_RS
- Publication Year :
- 2017
- Publisher :
- Springer Science and Business Media LLC, 2017.
-
Abstract
- Considering that pulmonary arterial obstruction decreases venous flow, we hypothesized that filling defects in pulmonary veins can be identified in areas adjacent to pulmonary embolism (PE). This sign was named the “pulmonary vein sign” (PVS), and we evaluated its prevalence and performance for PE diagnosis in computed tomography pulmonary angiography (CTPA). This retrospective study enrolled consecutive patients with clinical suspicion of PE who underwent CTPA scan. The PVS was defined by the following criteria: (a) presence of a homogeneous filling defect of at least 2 cm in a pulmonary vein; (b) attenuation of the left atrium > 160 Hounsfield units. Using the cases that presented PE on CTPA as reference, sensitivity, specificity, and positive and negative predictive values were calculated for PVS. In total, 119 patients (73 female; mean age, 62 years) were included in this study. PE was diagnosed in 44 (35.8%) patients. The PVS was present in 16 out of 44 patients with PE. Sensitivity was 36.36% (95% confidence interval (CI) 22.83–52.26%); specificity, 98.67% (95% CI 91.79–99.93%); positive predictive value, 94.12% (95% CI 69.24–99.69%); negative predictive value, 72.55% (95% CI 62.67–80.70%). The Kappa index for the PVS was good (0.801; 95% CI 0.645–0.957). PVS was correlated with lobar and segmental pulmonary embolism (p
- Subjects :
- Adult
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Adolescent
Computed Tomography Angiography
030204 cardiovascular system & hematology
030218 nuclear medicine & medical imaging
Pulmonary vein
Young Adult
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Positive predicative value
Hounsfield scale
Pulmonary angiography
Humans
Medicine
Heart Atria
Child
Aged
Retrospective Studies
Computed tomography angiography
Aged, 80 and over
Observer Variation
medicine.diagnostic_test
business.industry
Retrospective cohort study
Middle Aged
medicine.disease
Confidence interval
Pulmonary embolism
Pulmonary Veins
cardiovascular system
Female
Radiology
Pulmonary Embolism
business
Subjects
Details
- ISSN :
- 14321750 and 03412040
- Volume :
- 195
- Database :
- OpenAIRE
- Journal :
- Lung
- Accession number :
- edsair.doi.dedup.....ee26ae8e9867ce3ab7fa24305a6501b5
- Full Text :
- https://doi.org/10.1007/s00408-017-0057-7