Multidetector-row computed tomography management of acute pulmonary embolism.
BACKGROUND
The purpose of this study was to evaluate the usefulness and safety of multidetector-row computed tomography (MDCT) pulmonary angiography and indirect venography management of acute pulmonary embolism (PE), including indication for inferior vena cava (IVC) filter.


RESULTS
Seventy-one consecutive patients who were clinically suspected of PE and underwent 16-slice MDCT pulmonary angiography and indirect venography were enrolled. Management included indication of IVC filter for patients with extensive deep venous thrombosis (DVT) in submassive or massive PE. A right ventricular to left ventricular short-axis diameter by MDCT>1.0 was judged as submassive PE. All patients were followed for 1 year. MDCT identified 50 patients with venous thromboembolism and 47 patients had acute PE: 4 were judged as massive, 14 as submassive, and 29 as non-massive by MDCT; 3 patients had DVT alone and 7 patients had caval or iliac DVT. Only 1 patient with massive PE and DVT near the right atrium died of recurrence. No other patients died of PE.


CONCLUSIONS
Management based on MDCT pulmonary angiography combined with indirect venography is considered to be safe and reliable in patients with suspected acute PE.
Department of Respirology, Graduate School of Medicine, Chiba University, and Department of Radiology, Chiba University Hospital, Japan.
Takahiro
T
Yasui
Nobuhiro
N
Tanabe
Jiro
J
Terada
Noriyuki
N
Yanagawa
Hidefumi
H
Shimizu
Hiroshi
H
Matsubara
Susumu
S
Hoshino
Ayako
A
Fujikawa
Satoko
S
Mizuno
Mari
M
Yatomi
Seiichiro
S
Sakao
Takahiro
T
Uruma
Yasunori
Y
Kasahara
Yuichi
Y
Takiguchi
Koichiro
K
Tatsumi
Takayuki
T
Kuriyama
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D011655:Pulmonary Embolism / Q000145:classification / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D016306:Vena Cava Filters; D020246:Venous Thrombosis / Q000000981:diagnostic imaging