Pulmonary embolism in pregnancy: comparison of pulmonary CT angiography and lung scintigraphy.

Hdl Handle:
http://hdl.handle.net/10147/207607
Title:
Pulmonary embolism in pregnancy: comparison of pulmonary CT angiography and lung scintigraphy.
Authors:
Ridge, Carole A; McDermott, Shaunagh; Freyne, Bridget J; Brennan, Donal J; Collins, Conor D; Skehan, Stephen J
Affiliation:
Department of Radiology, St Vincent's University Hospital, Elm Park, Dublin 4,, Ireland. caroleridge@hotmail.com
Citation:
AJR Am J Roentgenol. 2009 Nov;193(5):1223-7.
Journal:
AJR. American journal of roentgenology
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207607
DOI:
10.2214/AJR.09.2360
PubMed ID:
19843734
Abstract:
OBJECTIVE: The purpose of this study was to retrospectively compare the diagnostic adequacy of lung scintigraphy with that of pulmonary CT angiography (CTA) in the care of pregnant patients with suspected pulmonary embolism. MATERIALS AND METHODS: Patient characteristics, radiology report content, additional imaging performed, final diagnosis, and diagnostic adequacy were recorded for pregnant patients consecutively referred for lung scintigraphy or pulmonary CTA according to physician preference. Measurements of pulmonary arterial enhancement were performed on all pulmonary CTA images of pregnant patients. Lung scintigraphy and pulmonary CTA studies deemed inadequate for diagnosis at the time of image acquisition were further assessed, and the cause of diagnostic inadequacy was determined. The relative contribution of the inferior vena cava to the right side of the heart was measured on nondiagnostic CTA images and compared with that on CTA images of age-matched nonpregnant women, who were the controls. RESULTS: Twenty-eight pulmonary CTA examinations were performed on 25 pregnant patients, and 25 lung scintigraphic studies were performed on 25 pregnant patients. Lung scintigraphy was more frequently adequate for diagnosis than was pulmonary CTA (4% vs 35.7%) (p = 0.0058). Pulmonary CTA had a higher diagnostic inadequacy rate among pregnant than nonpregnant women (35.7% vs 2.1%) (p < 0.001). Transient interruption of contrast material by unopacified blood from the inferior vena cava was identified in eight of 10 nondiagnostic pulmonary CTA studies. CONCLUSION: We found that lung scintigraphy was more reliable than pulmonary CTA in pregnant patients. Transient interruption of contrast material by unopacified blood from the inferior vena cava is a common finding at pulmonary CTA of pregnant patients.
Language:
eng
MeSH:
Adolescent; Adult; Chi-Square Distribution; Contrast Media; Female; Humans; Image Interpretation, Computer-Assisted; Iopamidol/diagnostic use; Middle Aged; Pregnancy; Pregnancy Complications, Cardiovascular/*radiography/*radionuclide imaging; Pulmonary Embolism/*radiography/*radionuclide imaging; Radiopharmaceuticals/diagnostic use; Retrospective Studies; Technetium Tc 99m Aggregated Albumin/diagnostic use; Tomography, X-Ray Computed/*methods
ISSN:
1546-3141 (Electronic); 0361-803X (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorRidge, Carole Aen_GB
dc.contributor.authorMcDermott, Shaunaghen_GB
dc.contributor.authorFreyne, Bridget Jen_GB
dc.contributor.authorBrennan, Donal Jen_GB
dc.contributor.authorCollins, Conor Den_GB
dc.contributor.authorSkehan, Stephen Jen_GB
dc.date.accessioned2012-02-01T10:32:43Z-
dc.date.available2012-02-01T10:32:43Z-
dc.date.issued2012-02-01T10:32:43Z-
dc.identifier.citationAJR Am J Roentgenol. 2009 Nov;193(5):1223-7.en_GB
dc.identifier.issn1546-3141 (Electronic)en_GB
dc.identifier.issn0361-803X (Linking)en_GB
dc.identifier.pmid19843734en_GB
dc.identifier.doi10.2214/AJR.09.2360en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207607-
dc.description.abstractOBJECTIVE: The purpose of this study was to retrospectively compare the diagnostic adequacy of lung scintigraphy with that of pulmonary CT angiography (CTA) in the care of pregnant patients with suspected pulmonary embolism. MATERIALS AND METHODS: Patient characteristics, radiology report content, additional imaging performed, final diagnosis, and diagnostic adequacy were recorded for pregnant patients consecutively referred for lung scintigraphy or pulmonary CTA according to physician preference. Measurements of pulmonary arterial enhancement were performed on all pulmonary CTA images of pregnant patients. Lung scintigraphy and pulmonary CTA studies deemed inadequate for diagnosis at the time of image acquisition were further assessed, and the cause of diagnostic inadequacy was determined. The relative contribution of the inferior vena cava to the right side of the heart was measured on nondiagnostic CTA images and compared with that on CTA images of age-matched nonpregnant women, who were the controls. RESULTS: Twenty-eight pulmonary CTA examinations were performed on 25 pregnant patients, and 25 lung scintigraphic studies were performed on 25 pregnant patients. Lung scintigraphy was more frequently adequate for diagnosis than was pulmonary CTA (4% vs 35.7%) (p = 0.0058). Pulmonary CTA had a higher diagnostic inadequacy rate among pregnant than nonpregnant women (35.7% vs 2.1%) (p < 0.001). Transient interruption of contrast material by unopacified blood from the inferior vena cava was identified in eight of 10 nondiagnostic pulmonary CTA studies. CONCLUSION: We found that lung scintigraphy was more reliable than pulmonary CTA in pregnant patients. Transient interruption of contrast material by unopacified blood from the inferior vena cava is a common finding at pulmonary CTA of pregnant patients.en_GB
dc.language.isoengen_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshAdulten_GB
dc.subject.meshChi-Square Distributionen_GB
dc.subject.meshContrast Mediaen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshImage Interpretation, Computer-Assisteden_GB
dc.subject.meshIopamidol/diagnostic useen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshPregnancyen_GB
dc.subject.meshPregnancy Complications, Cardiovascular/*radiography/*radionuclide imagingen_GB
dc.subject.meshPulmonary Embolism/*radiography/*radionuclide imagingen_GB
dc.subject.meshRadiopharmaceuticals/diagnostic useen_GB
dc.subject.meshRetrospective Studiesen_GB
dc.subject.meshTechnetium Tc 99m Aggregated Albumin/diagnostic useen_GB
dc.subject.meshTomography, X-Ray Computed/*methodsen_GB
dc.titlePulmonary embolism in pregnancy: comparison of pulmonary CT angiography and lung scintigraphy.en_GB
dc.contributor.departmentDepartment of Radiology, St Vincent's University Hospital, Elm Park, Dublin 4,, Ireland. caroleridge@hotmail.comen_GB
dc.identifier.journalAJR. American journal of roentgenologyen_GB
dc.description.provinceLeinster-

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