Pulmonary embolism in pregnancy: comparison of pulmonary CT angiography and lung scintigraphy.
AuthorsRidge, Carole A
Freyne, Bridget J
Brennan, Donal J
Collins, Conor D
Skehan, Stephen J
AffiliationDepartment of Radiology, St Vincent's University Hospital, Elm Park, Dublin 4,, Ireland. email@example.com
Image Interpretation, Computer-Assisted
Pregnancy Complications, Cardiovascular/*radiography/*radionuclide imaging
Pulmonary Embolism/*radiography/*radionuclide imaging
Technetium Tc 99m Aggregated Albumin/diagnostic use
Tomography, X-Ray Computed/*methods
MetadataShow full item record
CitationAJR Am J Roentgenol. 2009 Nov;193(5):1223-7.
JournalAJR. American journal of roentgenology
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.
- Pulmonary CT angiography protocol adapted to the hemodynamic effects of pregnancy.
- Authors: Ridge CA, Mhuircheartaigh JN, Dodd JD, Skehan SJ
- Issue date: 2011 Nov
- Pulmonary embolism during pregnancy: diagnosis with lung scintigraphy or CT angiography?
- Authors: Revel MP, Cohen S, Sanchez O, Collignon MA, Thiam R, Redheuil A, Meyer G, Frija G
- Issue date: 2011 Feb
- Transient interruption of contrast on CT pulmonary angiography: proof of mechanism.
- Authors: Wittram C, Yoo AJ
- Issue date: 2007 May
- Pulmonary 64-MDCT angiography with 30 mL of IV contrast material: vascular enhancement and image quality.
- Authors: Wu CC, Lee EW, Suh RD, Levine BS, Barack BM
- Issue date: 2012 Dec
- Chest radiograph as a triage tool in the imaging-based diagnosis of pulmonary embolism.
- Authors: Daftary A, Gregory M, Daftary A, Seibyl JP, Saluja S
- Issue date: 2005 Jul