Abstract
BackgroundThe advantages of multi-detector computed tomography (MDCT) have made it the imaging modality of choice for some patients with suspected cardiothoracic disease, of which pulmonary embolism (PE) is an exponent. The aim of this study was to assess the incidence of PE in patients with clinical suspicion of acute PE using MDCT in a sub-Saharan setting, and to describe the demographic characteristics of these patients.MethodsConsecutive records of patients who underwent MDCT pulmonary angiography for suspected acute PE over a two-year period at the Radiology Department of a university-affiliated hospital were systematically reviewed. All MDCT pulmonary angiograms were performed with a 16-detector computed tomography (CT) scanner using real-time bolus tracking technique. Authorization for the study was obtained from the institutional authorities.ResultsForty-one MDCT pulmonary angiograms were reviewed of which 37 were retained. Of the 4 excluded studies, 3 were repeat angiograms and 1 study was not technically adequate. Twelve of 37 patients (32.4%) had CT angiograms that were positive for PE, of which 7 were males. The mean age of these patients was 47.6±10.5 years (age range from 33 to 65 years). Twenty five patients out of 37 (67.6%) had CT angiograms that were negative for PE. Eleven PE-positive patients (91.7%) had at least 1 identifiable thromboembolic risk factor whilst 5 PE-negative patients (20%) also had at least a thromboembolic risk factor. The relative risk of the occurrence of PE in patients with at least a thromboembolic risk factor was estimated at 14.4.ConclusionAcute PE is a reality in sub-Saharan Africa, with an increased likelihood of MDCT evidence in patients with clinical suspicion of PE who have at least a thromboembolic risk factor. The increasing availability of MDCT will help provide more information on the occurrence of PE in these settings.
Highlights
The advantages of multi-detector computed tomography (MDCT) have made it the imaging modality of choice for some patients with suspected cardiothoracic disease, of which pulmonary embolism (PE) is an exponent
Twelve of 37 patients (32.4%) had CT angiograms that were positive for PE, with a mean age of 47.6±10.5 years
Significant findings in PE-negative patients included 5 cases of lung consolidation, 2 cases of ground glass opacities, 4 cases of pleural effusions, a case of pericardial effusion, 3 cases of aneurysms of the thoracic aorta and a case of aneurysm of the main pulmonary artery (Figures 2 and 3). From these results acute PE is not as rare a finding in sub-Saharan African populations as previously reported [9], after obtaining as high as 32% MDCT angiograms that were positive for PE
Summary
The advantages of multi-detector computed tomography (MDCT) have made it the imaging modality of choice for some patients with suspected cardiothoracic disease, of which pulmonary embolism (PE) is an exponent. Multi-detector computed tomography (MDCT) pulmonary angiography is increasingly being used to evaluate patients with suspected pulmonary embolism (PE) [1] This is largely due to its many advantages over conventional angiography whose place as a diagnostic standard of reference has been increasingly challenged [2]. Little is known about the occurrence of acute pulmonary embolism (PE) in sub-Saharan settings Considered rare, it has often been diagnosed based on clinical symptoms in patients with or without evidence of deep vein thrombosis on Doppler ultrasound [9]. The purpose of this study was to assess the incidence of PE in patients with clinical suspicion of acute PE using MDCT in a sub-Saharan setting, and to describe the demographic characteristics of these patients
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