title: [Spiral CT angiography in the diagnosis of central pulmonary embolism: comparison with pulmonary angiography and scintigraphy].
abstract: OBJECTIVE
  To evaluate the accuracy of spiral CT angiography in the diagnosis of central pulmonary embolism (PE).
  
  
  METHODS
  A retrospective study was undertaken in a population of 90 patients who were evaluated with spiral CT angiography (acquisition: 12 to 24 s with or without strict apnea; injection of 90 cm3 of 12, 20 or 30% contrast material at a rate of 4 to 7 cm3, selective pulmonary angiography of each lung (n = 55) and/or ventilation-perfusion (VP) scanning (n = 35).
  
  
  RESULTS
  Among the 55 patients evaluated with both spiral CT and angiography, central pulmonary embolism was excluded in 19 patients (34%), assessed in 29 patients (53%) whereas CT examination was considered as inconclusive in 7 patients (13%) due to interpretive difficulties at the level of obliquely oriented arteries and/or presence of hilar lymph nodes (sensitivity: 90.5%; specificity: 82.6%). With spiral CT, the finding of 95 central emboli (3 main, 61 lobar and 31 segmental) corresponded exactly to the angiographic findings; spiral CT enabled direct visualization of intraluminal filling defects (n = 95) whereas the angiographic recognition of PE was based on direct (n = 57) and indirect (n = 38) signs. Spiral CT angiography was more sensitive and specific than VP scanning.
  
  
  CONCLUSIONS
  Spiral CT angiography appears as a sensitive and specific noninvasive method for the diagnosis of central PE.
authors.affiliation: Service de Radiologie, Hôpital Calmette, Lille.
authors.forename: O
authors.initials: O
authors.lastname: Cauvain
authors.forename: M
authors.initials: M
authors.lastname: Rémy-Jardin
authors.forename: J
authors.initials: J
authors.lastname: Rémy
authors.forename: L
authors.initials: L
authors.lastname: Petyt
authors.forename: J P
authors.initials: JP
authors.lastname: Beregi
authors.forename: M
authors.initials: M
authors.lastname: Steinling
authors.forename: A
authors.initials: A
authors.lastname: Duhamel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D011875:Radionuclide Angiography; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014692:Ventilation-Perfusion Ratio
vernacular_title: Tomodensitométrie par balayage spirale volumique dans le diagnostic de l'embolie pulmonaire centrale: comparaison avec l'angiographie pulmonaire et la scintigraphie pulmonaire.