Acute pulmonary embolism: ancillary findings at spiral CT.
OBJECTIVE
To determine the value of parenchymal findings at contrast material-enhanced spiral computed tomography (CT) in patients suspected to have pulmonary embolism (PE).


METHODS
Eighty-eight patients suspected to have PE underwent contrast-enhanced spiral CT and ventilation-perfusion scintigraphy. Concordance between CT and scintigraphic results was used to diagnose or exclude PE. Pulmonary angiography was attempted in all patients with discordant CT and scintigraphic results or indeterminate scans. Parenchymal CT scans were assessed by two radiologists who were not aware of the diagnosis and who had access only to lung window images.


RESULTS
Twenty-six patients had PE; 62 did not. Wedge-shaped pleural-based consolidation was seen in 16 patients with PE (62%) and 17 patients without PE (27%) (P < .05) (sensitivity, 62%; specificity, 73%). Linear bands were seen in 12 patients with PE (46%) and 13 patients without PE (21%) (P < .05) (sensitivity, 46%; specificity, 79%). There was no statistically significant difference in the frequency of non-wedge-shaped consolidation, areas of decreased attenuation, or atelectasis. Central and lower-lobe segmental pulmonary arteries that contained emboli were enlarged (P < .05).


CONCLUSIONS
Parenchymal findings may suggest further investigations when results of spiral CT are inconclusive in diagnosis of PE.
Coche
E E
EE
Department of Radiology, Vancouver Hospital and Health Sciences Centre, University of British Columbia, Canada.
Müller
N L
NL
Kim
K I
KI
Wiggs
B R
BR
Mayo
J R
JR
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D014283:Triiodobenzoic Acids
D003287:Contrast Media; D014283:Triiodobenzoic Acids; C054871:ioversol