Abstract
The aim of our study was to investigate the contribution of CT angiography in cases with a presumptive PTE diagnosis, evaluating lower extremity veins with CT venography and color Doppler ultrasonography (CDU) and the role of these methods at diagnosis of DVT. 46 patients with presumptive diagnosis of PTE which was confirmed with a positive CT angiography (CTA) were included in the study. Lower extremities between the iliac crest and head of femur and the popliteal region were scanned having 17-18 slices from each area, without administring extra contrast medium with a 0.8 mm slice gap. The patients underwent lower extremity CDU on the same day. Four out of 46 patients were shown to have thrombus by CDU while their CTV were normal. Two of them had an appearance of thrombus on CTV while their CDU were normal. When we consider CDU as the gold standard method, the sensitivity of CTV is calculated as 81.8% and the specificity as 91.6%. Kappa value between two modalities was calculated as 0.738 and a consistency of 87% is found. Mean radiation dose was calculated as 2.43 mSv for CTA and 0.457 mSv for CTV. With the imaging technique so-called combined CTA-indirect CTV method, DVT can be determined with moderate sensitivity and high specificity with application of low dose extra radiation.
Highlights
Pulmonary tromboembolism (PTE) and venous thromboembolism (VTE) are common disorders which can be fatal and require urgent treatment [1]
Pulmonay CT angiography (CTA) and CTV images were evaluated in terms of PTE and deep ven trombosis (DVT), respectively
Whereas the minimum and maximum values measured from main femoral vein were 75 and 140 Hounsfield Units (HU), respectively, the mean value was determined as 95 HU
Summary
Pulmonary tromboembolism (PTE) and venous thromboembolism (VTE) are common disorders which can be fatal and require urgent treatment [1]. It is the most frequently encountered emergency condition observed following surgical intervention, delivery, long bed rest and trauma [2]. Pulmonery embolism can present with myriad manifestations. In many of the cases, diagnosis is made in autopsy. Clinical prediction rules and laboratory tests are employed to assess the possibility of pulmoner embolism. Definitive diagnosis is often made via imaging methods [3]. Ninenty percent of the PTE cases results from deep ven trombosis (DVT) [4]
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