Abstract
With the development of computed tomography, tomography examinations have been replacing other modalities of imaging tests. Computed tomography angiography to pulmonary thromboembolism, for example, has been replacing pulmonary scintigraphy of ventilation/perfusion and angiography of pulmonary vessels. But angiotomography to the pulmonary thromboembolism is a complex examination, where factors such as scanning time, contrast injection flow, venous access caliber, venous access puncture site, use of the contrast injector, auto-trigger parameters, among others, interfere in the outcome of exam in the studied population. In this study, we performed the contrast ratio (RZC), relative the opacification of contrast in the trunk of the pulmonary artery and the descending aorta, which may vary according to the injection protocol used, determined by the flow of contrast injection (ml/s) associated with the auto-trigger (HU) parameters of the density reading in automatic mode of the equipment. For the injection of manual contrast, and its mean and standard deviation of RZC (2.66±3.56), for the flow (ml/s) and automatics reading (HU) protocols the means and standard deviations RZC consecutively are: 3.5 ml/s and 90 HU (3.68±2.79); 3.5 ml/s and 70 HU (1.90±0.72); 4.0 ml/s and 70 HU (1.98±0.56); 3.0 ml/s and 80 HU (2.15±0.89); 3.5 ml/s and 80 HU (1.50±0.36); 4.0 ml/s and 80 HU (3.91±3.22); 4.5 ml/s and 80 HU (4.69±4.82); 5.0 ml/s and 80 HU (4.27±3.78). The technique with the best result in the average level of RZC was the one that used a flow of 4.5 ml/s and auto-trigger in 80 HU.
Highlights
With advances in image resolution and scanning time by computed tomography (CT) today, many imaging tests that were considered gold standard are being replaced by tomography examinations, either by cost, accessibility or being less invasive in relation to the other methods [1, 2].Computed tomography angiography (CTA) for the diagnosis of pulmonary thromboembolism (TEP) has been replacing in most cases, angiography of pulmonary vessels and pulmonary ventilation and perfusion scintigraphy, mainly because it is less invasive and low costly, besides presenting diagnostic capacity similar to the others methods [3,4].In Brazil and other Latin American countries there is a considerable lack of epidemiological data on venous thromboembolism
Decrease in injection flow when the access caliber is smaller than recommended;
It is verified that the selection of the appropriate technique plays a fundamental role in the outcome of CTA for TEP, greatly contributing to the quality of the examination to establish a definitive diagnosis to the patient, avoiding the repetition of examinations or even if it is submitted to other tests in radiology the dose of radiation to which the patient may be exposed
Summary
With advances in image resolution and scanning time by computed tomography (CT) today, many imaging tests that were considered gold standard are being replaced by tomography examinations, either by cost, accessibility or being less invasive in relation to the other methods [1, 2].Computed tomography angiography (CTA) for the diagnosis of pulmonary thromboembolism (TEP) has been replacing in most cases, angiography of pulmonary vessels and pulmonary ventilation and perfusion scintigraphy, mainly because it is less invasive and low costly, besides presenting diagnostic capacity similar to the others methods [3,4].In Brazil and other Latin American countries there is a considerable lack of epidemiological data on venous thromboembolism. Computed tomography angiography (CTA) for the diagnosis of pulmonary thromboembolism (TEP) has been replacing in most cases, angiography of pulmonary vessels and pulmonary ventilation and perfusion scintigraphy, mainly because it is less invasive and low costly, besides presenting diagnostic capacity similar to the others methods [3,4]. Knowing the Brazilian reality, the study points out that factors such as inequality in access to health care, the quality of services provided in health care and the difficulties of a clinical diagnosis for TEP that contribute to a possible underestimation of the mortality rates by TEP, fact reinforced by the low rates of mortality for TEP in Brazil compared to the United States and Europe [5, 6]. There are undiagnosed cases as a consequence of nonspecific symptoms, such as chest pain, shortness of breath, tachycardia among others, which are confused with other pulmonary and cardiac disorders [7, 8]
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