Screening of extravascular findings in pulmonary embolism computer tomography: 397 patients with 1950 non-pulmonary artery findings

Vascular. 2018 Feb;26(1):99-110. doi: 10.1177/1708538117724628. Epub 2017 Aug 18.

Abstract

Objectives The aim of this study was to investigate the possible benefits from computed tomography scans of patients with a suspected pulmonary artery embolism with a focus on relevant extravascular findings. Methods A total of 400 consecutive computed tomography pulmonary angiographies were evaluated. Computed tomography scans were analyzed in detail for the presence of pulmonary artery embolisms, as well as any other findings. Extra-artery discoveries were classified into none-relevant (Group A), intermediate (Group B), or relevant (Group C) findings. Results Aggregated computed tomography pulmonary angiographies detected other diagnosis than pulmonary artery embolism in 236 patients (59%). There were 1950 non-pulmonary artery embolism findings (4.9 per patient; n = 397). In the pulmonary artery embolism group, there were 447 extra-pulmonary artery embolism findings (5.2 per patient; n = 86) and in the non-pulmonary artery embolism group, 1503 findings (4.8 per patient; n = 311). Patients with pulmonary artery embolism had a significantly higher rate of pro-coagulate risk factors ( p < 0.001). Conclusions Computed tomography pulmonary angiographies may help to identify further diagnoses. This study represents a retrospective review of a single center experience for incidental computed tomography findings during pulmonary artery embolism work-up and emphasizes the importance of analyzing the whole field-of-view.

Keywords: D-dimer; Pulmonary artery embolism; angiography; computed tomography; risk factors; thoracic anatomy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Computed Tomography Angiography*
  • Female
  • Fibrin Fibrinogen Degradation Products / analysis
  • Germany
  • Humans
  • Incidental Findings*
  • Male
  • Middle Aged
  • Multidetector Computed Tomography*
  • Predictive Value of Tests
  • Pulmonary Artery / diagnostic imaging*
  • Pulmonary Embolism / blood
  • Pulmonary Embolism / diagnostic imaging*
  • Retrospective Studies

Substances

  • Biomarkers
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D