Computed Tomography Angiograms Performed for Patients with Suspected Pulmonary Embolism

Abstract

Background: Pulmonary embolism is a known condition in the emergency department with high morbidity and mortality. Computed tomography pulmonary angiography (CTPA) is a rapid diagnostic tool to detect pulmonary embolism however, the number of positive scans has decreased and the frequency of observed non-embolic findings has increased over time as this tool has been overutilized to provide other alternative diagnoses. Objective: This study aims to estimate the prevalence of pulmonary embolism and non-embolic findings in patients who underwent CT pulmonary angiography for suspected pulmonary embolism. Design and Setting: In this cross-sectional study we retrospectively analyzed consecutive 158 CTPA images and reports performed for suspected pulmonary embolism at a Saudi tertiary care hospital. The non-embolic findings were classified based on their location. Results: The prevalence of pulmonary embolism was 26.6%. No statistically significant difference was found between the diagnosis of pulmonary embolism with respect to gender and age. The prevalence of non-embolic findings among the whole study was 86.7%. Pulmonary findings represented 45.2% of all non-embolic findings followed by pleural findings in 18.3%. Lung opacification and pleural effusion were the most commonly occurring findings. Conclusion: Relative to other studies our center has a reasonable prevalence of CTPA studies being positive for pulmonary embolism however, we encourage balancing the potential benefits and harms by following a well-structured clinical approach to improve the healthcare quality and safety.