CT venography vs ultrasound in the diagnosis of thromboembolic disease in patients with clinical suspicion of pulmonary embolism.
To assess the reliability of indirect computed tomography venography (CTV) in the detection of deep venous thrombosis (DVT) in patients with clinical suspicion of pulmonary embolism (PE). 235 consecutive patients with suspicion of PE underwent an imaging protocol composed of a CT pulmonary angiography (CTPA), a CTV and an ultrasound study of the deep venous system, which was considered the "gold standard." Sensitivity, specificity, and predictive values were calculated for CTV. ith CTV, 30 (12.8%) cases of DVT were detected, 9 (3.8%) of them without pulmonary embolism in CTPA, increasing the diagnosis of thromboembolic disease in 3.8%. However, six of these nine diagnoses were false positives, and CTV missed six cases of DVT. CTV rendered a sensitivity of 58.8%, specificity of 95.0%, a positive predictive value of 66.7%, and a negative predictive value of 93.2%. In patients with clinical suspicion of pulmonary embolism, ultrasound is preferred to CTV for the detection of DVT.
Garcia-Bolado
Ana
A
Servicio de Radiodiagnóstico, Hospital Universitario Marqués de Valdecilla, Av. Marqués de Valdecilla 25, 39008, Santander, Cantabria, Spain. anagbolado@hotmail.com
Del Cura
Jose L
JL
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007472:Iohexol; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000209:etiology; D012680:Sensitivity and Specificity; D013923:Thromboembolism / Q000150:complications / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D003287:Contrast Media; D007472:Iohexol