Pulmonary embolism in pregnancy: comparison of pulmonary CT angiography and lung scintigraphy.
Authors
Ridge, Carole AMcDermott, 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.comIssue Date
2012-02-01T10:32:43ZMeSH
AdolescentAdult
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
Metadata
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AJR Am J Roentgenol. 2009 Nov;193(5):1223-7.Journal
AJR. American journal of roentgenologyDOI
10.2214/AJR.09.2360PubMed ID
19843734Abstract
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
engISSN
1546-3141 (Electronic)0361-803X (Linking)
ae974a485f413a2113503eed53cd6c53
10.2214/AJR.09.2360
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