Evaluation of spiral computed tomography versus ventilation/perfusion scanning in patients clinically suspected of pulmonary embolism.
OBJECTIVE
To prospectively evaluate the diagnostic accuracy of spiral computed tomography (CT) versus ventilation/perfusion (V/Q) scanning in the examination of patients clinically suspected of having pulmonary embolism (PE).


METHODS
Sixty-three patients, presenting to the emergency department and departments of radiology and nuclear medicine of a large hospital, highly suspected of having PE, underwent sequential imaging testing with V/Q scanning and contrast-enhanced spiral CT, in addition to other clinical and laboratory tests.


RESULTS
PE was diagnosed in 42 (66.7%) of the 63 patients. Thirty-nine of these 42 patients had positive findings in their CT scans, while 18 of the remaining 21 patients without PE had negative findings in their spiral CT [sensitivity, 92.9%, specificity, 85.7% Positive Predictive Value (PPV), 92.9%, Negative Predictive Value (NPV), 85.7%]. V/Q scans showed high-probability of PE in 24 of the 42 patients with PE and were negative in 9 of the remaining 21 patients without PE (sensitivity, 571%, specificity, 42.9%, PPV, 66.7%, NPV, 33.3%). There were statistically significant differences in specificity and sensitivity favoring spiral CT among men and women patients or patients > 50 years old. Fifty-four patients (85.7%) rated their satisfaction towards spiral CT as 'good' or 'very good', whereas the respective rate for V/Q scanning was only 14.3%.


CONCLUSIONS
Spiral CT has an excellent sensitivity, specificity, PPV and NPV for the diagnosis of PE and it could be used as the first-line imaging modality in patients suspected of PE.
Katsouda
Emmanouela
E
Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, University of Athens, 27 Korinthias Str., 115 26 Athens, Greece.
Mystakidou
Kyriaki
K
Rapti
Aggeliki
A
Argentos
Stelios
S
Kelekis
Nikolaos L
NL
Mastorakou
Renata
R
Anagnostopoulou
Ourania
O
Kelekis
Dimitrios A
DA
D000293:Adolescent; D000328:Adult; D000368:Aged; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014692:Ventilation-Perfusion Ratio