title: Reduced z-axis technique for CT Pulmonary angiography in pregnancy--validation for practical use and dose reduction.
abstract: The aim of this study is to determine the feasibility of using reduced scan range CT pulmonary angiography technique in pregnancy for pulmonary embolism (PE) and to quantify resulting dose reduction. This was a retrospective study. Eighty-four CTPA exams performed on pregnant women during 2004-2012. The scans were modified to create reduced anatomic coverage scans extending from aortic arch to base of heart. These were separately evaluated by two radiologists for PE and non-PE abnormalities. The results were then compared by the third radiologist with original radiology report and scans. Radiation dose reduction was evaluated prospectively in 36 patients as part of a quality control project. Two patients had PE and were successfully identified on reduced z-axis scans. Thirty-two exams were normal; rest had 60 pertinent and 16 had incidental findings. There were four incidental findings which included three benign thyroid nodules and one benign small lung nodule which were missed. None of these affected clinical outcome or management. There was 71 % radiation dose reduction. No PE or any important diagnoses are missed using reduced z-axis CTPA in pregnancy. There is a substantial radiation dose reduction. Hence, this technique is highly recommended in pregnancy.
authors: Department of Radiology, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI, 53226-3596, USA. kshahir@mcw.edu.
authors: Kaushik
authors: http://orcid.org/0000-0003-3375-1778
authors: K
authors: Shahir
authors: Department of Radiology, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI, 53226-3596, USA. jonathan.mccrea1@gmail.com.|X-Ray Consultants (XRC), 611 East Douglas Road, Suite 207, Mishawaka, IN, 46545, USA. jonathan.mccrea1@gmail.com.
authors: Jonathan M
authors: JM
authors: McCrea
authors: Department of Radiology, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI, 53226-3596, USA. antonsosaloz@yahoo.com.mx.|Instituto Nacional de Cardiologia, Juan Badiano No.1, Col. Sección XVI, Del. Tlalpan, C.P.14080, México, Distrito Federal, Mexico. antonsosaloz@yahoo.com.mx.
authors: Luis Antonio Sosa
authors: LA
authors: Lozano
authors: Department of Radiology, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI, 53226-3596, USA. lgoodman@mcw.edu.
authors: Lawrence R
authors: LR
authors: Goodman
mesh_terms: D000328:Adult; D000792:Angiography / Q000379:methods*; D016022:Case-Control Studies; D003287:Contrast Media; D004630:Emergencies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007472:Iohexol; D011247:Pregnancy; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D007472:Iohexol
keywords: CT; CTPA; Pregnancy; Pulmonary embolism; Radiation dose reduction