[The role of electron beam CT in the diagnosis of acute pulmonary embolism--presenting a new examination protocol].
OBJECTIVE
To evaluate electron beam tomography in the detection of acute pulmonary embolism using a new acquisition protocol.


METHODS
65 patients underwent electron beam tomography (EBT) and v./p. scintigraphy. According to the inclusion criteria 46 patients participated in the study. Contrast enhancement and detectability of pulmonary arteries were scored on a 4 step scale for image quality. The results of prospective detection of pulmonary embolism were compared for both modalities (blinded reading). "Embolism", "questionable embolism" and "no embolism" were used as categories.


RESULTS
22/46 patients (48%) showed acute pulmonary embolism. EBT and scintigraphy were discordant in 24% of patients. In EBT 1 false positive and 1 false negative case occurred, scintigraphy demonstrated 2 false negative and 3 false positive cases. 6/9 patients with questionable findings in scintigraphy were correctly classified by EBT to a category "embolism" or "no embolism" as "suspected embolism", EBT displayed a sensitivity of 96.3% and a specificity of 94.7%. Scintigraphy evidenced a sensitivity of 93.7% and a specificity of 84.4%.


CONCLUSIONS
EBT shows better results than scintigraphy for the detection of acute pulmonary emboli. The evaluated new acquisition protocol for EBT seems to be well suited. High vessel contrast and thin slices allow a reliable detection of segmental and subsegmental pulmonary arteries.
Lehmann
K J
KJ
Institut für Klinische Radiologie, Universitätsklinikum Mannheim gGmbH, Fakultät für Klinische Medizin Mannheim, Universität Heidelberg. lehmarad@rumms.uni-mannheim.de
Weisser
G
G
Naser
M
M
Denk
S
S
Willingstorfer
W J
WJ
Georgi
M
M
D000208:Acute Disease; D002985:Clinical Protocols; D003937:Diagnosis, Differential; D004583:Electrons; D006801:Humans; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000592:standards