Pulmonary embolism: Diagnosis with contrast-enhanced electron-beam CT and comparison with pulmonary angiography

C. L. Teigen, Timothy Maus, P. F. Sheedy, A. W. Stanson, C. M. Johnson, J. F. Breen, M. A. McKusick

Research output: Contribution to journalArticle

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Abstract

PURPOSE: To determine the sensitivity and specificity of contrast material-enhanced electron-beam computed tomography (CT) in the diagnosis of pulmonary embolism (PE). MATERIALS AND METHODS: Sixty patients suspected of having PE were prospectively evaluated with pulmonary angiography and contrast-enhanced electron-beam CT. Thirty-eight patients underwent ventilation-perfusion (V-P [also known as V/Q]) scanning. The pulmonary vasculature was divided into 12 anatomic zones. CT and angiographic findings were correlated on a patient-by-patient basis and for each vascular zone. RESULTS: Both studies were negative for PE in 36 patients. Both studies were positive in 15 patients, with the site of the emboli correlating well. Prospective sensitivity of CT was 65%; specificity, 97%; positive predictive value, 94%; and negative predictive value, 82%. After review of the nine discordant cases, sensitivity and specificity approached 100% for clinically important acute PE. CT depicted central and peripheral emboli equally well. CT was more sensitive and specific than V-P scanning. CONCLUSION: Electron- beam CT is a sensitive and specific noninvasive method for the diagnosis of PE. It has the potential to replace V-P scanning as the primary screening examination for PE.

Original languageEnglish (US)
Pages (from-to)313-319
Number of pages7
JournalRadiology
Volume194
Issue number2
StatePublished - 1995

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X Ray Computed Tomography
Pulmonary Embolism
Angiography
Lung
Tomography
Embolism
Sensitivity and Specificity
Contrast Media
Blood Vessels
Ventilation
Perfusion

Keywords

  • Embolism, pulmonary
  • Pulmonary angiography
  • Pulmonary arteries, CT

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Teigen, C. L., Maus, T., Sheedy, P. F., Stanson, A. W., Johnson, C. M., Breen, J. F., & McKusick, M. A. (1995). Pulmonary embolism: Diagnosis with contrast-enhanced electron-beam CT and comparison with pulmonary angiography. Radiology, 194(2), 313-319.

Pulmonary embolism : Diagnosis with contrast-enhanced electron-beam CT and comparison with pulmonary angiography. / Teigen, C. L.; Maus, Timothy; Sheedy, P. F.; Stanson, A. W.; Johnson, C. M.; Breen, J. F.; McKusick, M. A.

In: Radiology, Vol. 194, No. 2, 1995, p. 313-319.

Research output: Contribution to journalArticle

Teigen, CL, Maus, T, Sheedy, PF, Stanson, AW, Johnson, CM, Breen, JF & McKusick, MA 1995, 'Pulmonary embolism: Diagnosis with contrast-enhanced electron-beam CT and comparison with pulmonary angiography', Radiology, vol. 194, no. 2, pp. 313-319.
Teigen CL, Maus T, Sheedy PF, Stanson AW, Johnson CM, Breen JF et al. Pulmonary embolism: Diagnosis with contrast-enhanced electron-beam CT and comparison with pulmonary angiography. Radiology. 1995;194(2):313-319.
Teigen, C. L. ; Maus, Timothy ; Sheedy, P. F. ; Stanson, A. W. ; Johnson, C. M. ; Breen, J. F. ; McKusick, M. A. / Pulmonary embolism : Diagnosis with contrast-enhanced electron-beam CT and comparison with pulmonary angiography. In: Radiology. 1995 ; Vol. 194, No. 2. pp. 313-319.
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AB - PURPOSE: To determine the sensitivity and specificity of contrast material-enhanced electron-beam computed tomography (CT) in the diagnosis of pulmonary embolism (PE). MATERIALS AND METHODS: Sixty patients suspected of having PE were prospectively evaluated with pulmonary angiography and contrast-enhanced electron-beam CT. Thirty-eight patients underwent ventilation-perfusion (V-P [also known as V/Q]) scanning. The pulmonary vasculature was divided into 12 anatomic zones. CT and angiographic findings were correlated on a patient-by-patient basis and for each vascular zone. RESULTS: Both studies were negative for PE in 36 patients. Both studies were positive in 15 patients, with the site of the emboli correlating well. Prospective sensitivity of CT was 65%; specificity, 97%; positive predictive value, 94%; and negative predictive value, 82%. After review of the nine discordant cases, sensitivity and specificity approached 100% for clinically important acute PE. CT depicted central and peripheral emboli equally well. CT was more sensitive and specific than V-P scanning. CONCLUSION: Electron- beam CT is a sensitive and specific noninvasive method for the diagnosis of PE. It has the potential to replace V-P scanning as the primary screening examination for PE.

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