Reproducibility of multi-detector spiral computed tomography in detection of sub-segmental acute pulmonary embolism.
The aim of this study was to evaluate the inter-observer and intra-observer agreement of the diagnosis of sub-segmental acute pulmonary embolism (PE) in an inpatient population explored by 16 slice multi-detector spiral computed tomography (MDCT). Four hundred consecutive inpatients were referred for MDCT for the clinical suspicion of acute PE. One hundred and seventy seven (44.2%) had a known cardio-respiratory disease at the time of examination. Inter-observer and intra-observer agreements for the diagnosis of acute PE and of sub-segmental acute PE were assessed blind and independently by three experienced readers and by kappa statistics. Seventy-five patients were diagnosed as having acute PE findings (19.5%), and clots were located exclusively within sub-segmental arteries in nine patients (12%). When clots were limited to sub-segmental or more distal branches of the pulmonary arteries, kappa values were found to be moderate (0.56) to very good (0.85) for the diagnosis of sub-segmental acute PE, whereas for the diagnosis of acute PE in the whole population, kappa values ranged from 0.84 to 0.97. Intra-observer agreement was found to be perfect (kappa=1). MDCT is a reproducible technique for the diagnosis of sub-segmental acute PE as well as for acute PE. In this inpatient population, sub-segmental acute PE was not a rare event.
Brunot
S
S
Unité d'Imagerie Thoracique et Cardiovasculaire, Groupe Hospitalier Sud Hôpital du Haut-Lévêque, Avenue Magellan, 33604, Pessac, France.
Corneloup
O
O
Latrabe
V
V
Montaudon
M
M
Laurent
F
F
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed