title: Chest multidetector computed tomography (MDCT) in patients with suspected acute pulmonary embolism: diagnostic yield and proportion of other clinically relevant findings.
abstract: OBJECTIVE
  The authors evaluated the diagnostic yield of chest multidetector computed tomography (MDCT) in acute pulmonary embolism (PE) and the proportion of other clinically relevant findings in a large cohort of consecutive inpatients and patients referred from the emergency department (outpatients).
  
  
  METHODS
  A total of 327 radiological reports of chest MDCT scans performed for suspected acute PE in 327 patients (158 men, 169 women; mean age 69 years, standard deviation 17.33 years; 233 inpatients, 94 outpatients) were retrospectively evaluated and classified into four categories: 1, positive for PE; 2, negative for PE but positive for other findings requiring specific and immediate intervention; 3, completely negative or positive for findings with a potential for significant morbidity requiring specific action on follow-up; 4, indeterminate. The distribution of findings by categories among the entire population and inpatients and outpatients separately was calculated (chi-square test, α=0.05).
  
  
  RESULTS
  In the entire population, the diagnostic yield (i.e. proportion of cases classified as category 1) was 20.2% (66/327). Proportions of cases classified as categories 2, 3 and 4 were 27.5% (90/327), 44.3% (145/327) and 7.9% (26/327), respectively. No statistically significant difference was found between inpatients and outpatients (p=0.193).
  
  
  CONCLUSIONS
  In patients with suspected acute PE, chest MDCT provides evidence of conditions requiring immediate and specific intervention (i.e. categories 1 and 2) in nearly 50% of cases, without differences between inpatients and outpatients.
authors.affiliation: Institute of Diagnostic Radiology, University of Udine, Via Colugna 50, 33100, Udine, Italy. lcereser@sirm.org
authors.forename: L
authors.initials: L
authors.lastname: Cereser
authors.forename: D
authors.initials: D
authors.lastname: Bagatto
authors.forename: R
authors.initials: R
authors.lastname: Girometti
authors.forename: G
authors.initials: G
authors.lastname: Como
authors.forename: C
authors.initials: C
authors.lastname: Zuiani
authors.forename: M
authors.initials: M
authors.lastname: Bazzocchi
mesh_terms: D000208:Acute Disease; D000368:Aged; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods*