Computed tomography for suspected pulmonary embolism results in a large number of non-significant incidental findings and follow-up investigations

Emergency Radiology
Omar AnjumRobert Ohle

Abstract

Computed tomographic pulmonary angiograms (CTPAs) are often ordered to evaluate pulmonary embolism (PE) in the emergency department (ED). The increase use of CTPA has led to an increase in incidental findings, often of low clinical significance. Our objectives were to (1) assess the prevalence and clinical significance of incidental findings identified in patients evaluated with CTPAs for PE in the ED, (2) evaluate follow-up investigations for these incidental findings, and (3) assess the utility of routine chest X-rays done prior to CTPA. This is a historical cohort study of adult patients, presenting to two tertiary care EDs from January-December 2015, evaluated with CTPA for possible PE. Two reviewers' extracted data from electronic CT records in a standardized fashion with inter-rater reliability reported using the kappa statistic. We measured the prevalence of PE and stratified non-PE findings according to alternative diagnoses and incidental findings. Data were reported as mean and standard deviation (SD). Univariate analyses were performed with t test for continuous variables. A total of 1708 studies were included (mean 62 years (SD 16.7), 56.9% female). PE was found in 233 (13.6%) patients. A total of 223 (13.1%) patien...Continue Reading

References

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Citations

Oct 23, 2020·Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia·Michal BukTim Frederik Weber
Jun 10, 2020·European Journal of Radiology·Pierre BergeChristophe Aubé
Jun 1, 2021·Radiologic Clinics of North America·Lea AzourWilliam H Moore
Oct 30, 2021·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Marcelo G ValloneFernando J Vazquez

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