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

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    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
    Issue Date
    2012-02-01T10:32:43Z
    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
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    Citation
    AJR Am J Roentgenol. 2009 Nov;193(5):1223-7.
    Journal
    AJR. American journal of roentgenology
    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
    ISSN
    1546-3141 (Electronic)
    0361-803X (Linking)
    ae974a485f413a2113503eed53cd6c53
    10.2214/AJR.09.2360
    Scopus Count
    Collections
    St. Vincent's University Hospital

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