Possible pulmonary embolus: evaluation with digital subtraction versus cut-film angiography--prospective study in 80 patients

Radiology
M S JohnsonS O Trerotola

Abstract

To determine whether intraarterial digital subtraction angiography (DSA) is as accurate as cut-film (film hard-copy) angiography (CFA) in the evaluation of suspected pulmonary embolus. Under a protocol approved by the institutional review board, CFA and DSA images were obtained in identical posteroanterior and oblique projections in one lung of each patient undergoing pulmonary angiography (n = 80). Diagnoses based on results of blinded review of each study (CFA vs DSA) by three separate reviewers (80 patients x three reviewers = 240 diagnoses for each modality) were compared with the diagnoses made by the physician who performed the procedure on the basis of CFA, DSA, and clinical data and with the consensus diagnoses obtained by means of group review of both studies together if necessary. The reviewers' confidence in their diagnoses was graded from 1 (certain) to 10 (uncertain). Pulmonary emboli were present in 13 (16%) of 80 patients. Two hundred thirty-six (98.3%) of 240 DSA diagnoses and 231 (96.3%) of 240 CFA diagnoses were correct. The sensitivity (correct identification of emboli by all three reviewers) of DSA was 92% and of CFA was 69% (P = .083). The specificities of the modalities were not statistically significantly...Continue Reading

Citations

May 30, 2001·Computer Methods and Programs in Biomedicine·H TajimaT Takano
Sep 23, 2010·AJR. American Journal of Roentgenology·Scott O Trerotola, Reed E Pyeritz
Jun 5, 2003·Current Problems in Diagnostic Radiology·Lacey Washington, Meltem Gulsun
Aug 18, 2009·Journal of Vascular and Interventional Radiology : JVIR·Scott O TrerotolaBarbara A Bernhardt
Sep 9, 2008·Journal of Vascular and Interventional Radiology : JVIR·Asad NawazScott O Trerotola
Sep 21, 2000·Journal of Vascular and Interventional Radiology : JVIR·T E VellingL D Hall
Feb 24, 2001·Journal of Vascular and Interventional Radiology : JVIR·S O TrerotolaJ Dreesen
Feb 3, 2004·Magnetic Resonance in Medicine : Official Journal of the Society of Magnetic Resonance in Medicine·Aman JalaliRahim R Rizi
Jun 9, 2004·Seminars in Vascular Surgery·Sunita D SrivastavaLazar J Greenfield

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