Radiology 2000 Nov;217(2):447-55
Pulmonary embolism detection: prospective evaluation of dual-section
helical CT versus selective pulmonary arteriography in 157 patients.
Qanadli SD, Hajjam ME, Mesurolle B, Barre O, Bruckert F, Joseph T, Mignon F,
Vieillard-Baron A, Dubourg O, Lacombe P
PURPOSE: To evaluate the accuracy of dual-section helical computed tomography (CT) in
acute pulmonary embolism (PE) diagnosis. MATERIALS AND METHODS: Of 204 consecutive
patients with clinically suspected acute PE (mean age, 58 years +/- 14 [SD]), 158 were
enrolled. All patients underwent dual-section helical CT (2.7-mm effective section
thickness) and selective pulmonary arteriography within 12 hours of each other. Each image
was analyzed independently by two observers, who determined image quality and presence of
PE among arterial segments, including at the subsegmental level. The final diagnosis was
made with consensus. RESULTS: Selective pulmonary arteriography was considered optimal in
147 (93%), suboptimal in 10 (6%), and inconclusive in one (0.6%) of 158 patients.
Dual-section helical CT findings were considered technically optimal in 140 (89%),
suboptimal in 11 (7%), and inconclusive in six (4%). Selective pulmonary arteriography
demonstrated PE in 62 patients. Four (6%) of 62 patients had isolated subsegmental PE. The
sensitivity of dual-section helical CT was 90%, and the specificity was 94%. The positive
and negative predictive values were 90% and 94%, respectively. CONCLUSION: Dual-section
helical CT is an improvement in helical CT that offers a high sensitivity and specificity
for the depiction of PE, including at the subsegmental level. Dual-section helical CT can
replace pulmonary arteriography for the direct demonstration of PE in a majority of
patients.
PMID: 11058644, UI: 20514480
