title: Combined computed tomography venography and pulmonary angiography for the diagnosis PE and DVT in the ED.
abstract: The purpose of this study is to evaluate the usefulness of combined computed tomography venography and pulmonary angiography (CTVPA) in the diagnosis of venous thromboembolic (VTE) disease in the emergency department (ED). CTVPA images and clinical data of 73 nonselected patients with suspected pulmonary embolism (PE) and/or deep venous thrombosis (DVT) were retrospectively assessed. CTVPA correctly identified 33 of 34 patients with VTE disease, including 7 patients with PE alone, 11 patients with DVT alone, and 16 patients with both PE and DVT. Among the 27 patients with DVT, CTVPA disclosed thrombosis involving the abdominal and pelvic veins in 4 patients, and isolating to the inferior vena cava and iliac vein in one patient. CTVPA showed high accuracy in the diagnosis of both PE and DVT, in comparison with lower extremity venous sonography and ventilation-perfusion scintigraphy. In 26 (66%) of the 39 patients without of evidence VTE, CTVPA provided important ancillary information that suggests additional or alternative diagnoses. CTVPA is therefore an appropriate single diagnostic tool for evaluation VTE disease in the ED.
authors.affiliation: Department of Radiology, Chang Gung Memorial Hospital, Linkou, Taiwan, ROC. lkethm@adm.cgmh.org.tw
authors.forename: Kun Eng
authors.initials: KE
authors.lastname: Lim
authors.forename: Yuan Yu
authors.initials: YY
authors.lastname: Hsu
authors.forename: Wen Chen
authors.initials: WC
authors.lastname: Hsu
authors.forename: Chung Chi
authors.initials: CC
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging; D020246:Venous Thrombosis / Q000000981:diagnostic imaging*; D014692:Ventilation-Perfusion Ratio