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Unsuspected pulmonary embolism: prospective detection on routine helical CT scans.

Publication ,  Journal Article
Gosselin, MV; Rubin, GD; Leung, AN; Huang, J; Rizk, NW
Published in: Radiology
July 1998

PURPOSE: To determine the prevalence of unsuspected pulmonary embolism (PE) on routine thoracic helical computed tomographic (CT) scans and to quantify the improvement in PE detection by using a cine-paging mode on a workstation instead of hard-copy review. MATERIALS AND METHODS: Seven hundred eighty-five patients referred for routine contrast medium-enhanced thoracic CT within 9 months were prospectively recruited. Helical CT was performed. Studies were prospectively interpreted by four radiologists. Two radiologists performed routine, undirected, hard-copy consensus review for official interpretation; two of three thoracic radiologists independently performed a dedicated workstation-based search for PE. The presence of PE involving the main, lobar, or segmental pulmonary arteries was assigned a score of 1-5 (1 = definitely negative, 5 = definitely positive) by each independent reviewer. Patients with a score of 4 or 5 underwent lower-extremity ultrasound, ventilation-perfusion scintigraphy, or both, followed by pulmonary CT angiography if the findings were still equivocal. RESULTS: Twelve (1.5%) of the 785 patients had unsuspected PE, with an inpatient prevalence of 5% (eight of 160) and an outpatient prevalence of 0.6% (four of 625). Of the 12 patients with unsuspected PE, 10 (83%) had cancer. Of the 81 inpatients with cancer, seven (9%) had unsuspected PE. A dedicated workstation-based search resulted in detection of PE in three more patients (25%) than did hard-copy interpretation. CONCLUSION: The prevalence of unsuspected PE was highest among inpatients with cancer. A directed, workstation-based search can improve the PE detection rate over that with hard-copy review.

Duke Scholars

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Published In

Radiology

DOI

ISSN

0033-8419

Publication Date

July 1998

Volume

208

Issue

1

Start / End Page

209 / 215

Location

United States

Related Subject Headings

  • Ventilation-Perfusion Ratio
  • Ultrasonography
  • Tomography, X-Ray Computed
  • Radionuclide Imaging
  • Radiographic Image Enhancement
  • Pulmonary Embolism
  • Prospective Studies
  • Prevalence
  • Outpatients
  • Observer Variation
 

Citation

APA
Chicago
ICMJE
MLA
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Gosselin, M. V., Rubin, G. D., Leung, A. N., Huang, J., & Rizk, N. W. (1998). Unsuspected pulmonary embolism: prospective detection on routine helical CT scans. Radiology, 208(1), 209–215. https://doi.org/10.1148/radiology.208.1.9646815
Gosselin, M. V., G. D. Rubin, A. N. Leung, J. Huang, and N. W. Rizk. “Unsuspected pulmonary embolism: prospective detection on routine helical CT scans.Radiology 208, no. 1 (July 1998): 209–15. https://doi.org/10.1148/radiology.208.1.9646815.
Gosselin MV, Rubin GD, Leung AN, Huang J, Rizk NW. Unsuspected pulmonary embolism: prospective detection on routine helical CT scans. Radiology. 1998 Jul;208(1):209–15.
Gosselin, M. V., et al. “Unsuspected pulmonary embolism: prospective detection on routine helical CT scans.Radiology, vol. 208, no. 1, July 1998, pp. 209–15. Pubmed, doi:10.1148/radiology.208.1.9646815.
Gosselin MV, Rubin GD, Leung AN, Huang J, Rizk NW. Unsuspected pulmonary embolism: prospective detection on routine helical CT scans. Radiology. 1998 Jul;208(1):209–215.
Journal cover image

Published In

Radiology

DOI

ISSN

0033-8419

Publication Date

July 1998

Volume

208

Issue

1

Start / End Page

209 / 215

Location

United States

Related Subject Headings

  • Ventilation-Perfusion Ratio
  • Ultrasonography
  • Tomography, X-Ray Computed
  • Radionuclide Imaging
  • Radiographic Image Enhancement
  • Pulmonary Embolism
  • Prospective Studies
  • Prevalence
  • Outpatients
  • Observer Variation