Evaluation of the deep venous system in patients with suspected pulmonary embolism with multi-detector CT: a prospective study in comparison to Doppler sonography.
OBJECTIVE
This prospective study was done to evaluate the ability of indirect multidetector row CT venography (CTV) in detecting deep venous thrombosis of the pelvis and the thighs in comparison with Doppler sonography in patients with suspected pulmonary embolism (PE).


METHODS
Forty-one patients with suspected PE were included, and CTV (collimation 4 x 2.5 mm, table feed 12.5 mm, 120 kV, eff. mAs 165) from the iliac crest to the knees was done after CT angiography (CTA) of the pulmonary arteries. Doppler sonography was performed within 24 hours. Applied radiation doses were estimated using the PC program WinDose.


RESULTS
PE was diagnosed in 20 patients with additional DVT in 11 patients. The CTV has a sensitivity of 100%, specificity of 96.6%, a positive and negative predictive value of 91.7% and 100%, respectively. The median cumulative effective dose for CTV was 8.26 mSv with a gonadal dose of 3.87 mSv. Changing the CTV protocol to a collimation of 4 x 5 mm with a 25 mm table feed could reduce the dose by approximately 11% (p < 0.05) to 7.25 mSv and 3.35 mSv, respectively.


CONCLUSIONS
CTV is a safe and quick diagnostic tool for detecting DVT in patients with suspected PE. Due to the relevant increase in radiation dose, the indication has to be considered very carefully.
Begemann
Philipp G C
PG
Department of Diagnostic and Interventional Radiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany. p.begemann@uke.uni-hamburg.de
Bonacker
Michael
M
Kemper
Jörn
J
Guthoff
Angelika E
AE
Hahn
Kyungja E
KE
Steiner
Paul
P
Adam
Gerhard
G
D000368:Aged; D000792:Angiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D010388:Pelvis; D010690:Phlebography / Q000379:methods; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D012680:Sensitivity and Specificity; D013848:Thigh; D014057:Tomography, X-Ray Computed / Q000379:methods*; D018608:Ultrasonography, Doppler; D020246:Venous Thrombosis / Q000000981:diagnostic imaging*