AJR Am J Roentgenol 2001 Apr;176(4):1035-9
Using dual-detector helical CT angiography to detect deep venous
thrombosis in patients with suspicion of pulmonary embolism: diagnostic value and
additional findings.
Coche EE, Hamoir XL, Hammer FD, Hainaut P, Goffette PP.
OBJECTIVE: The purpose of this study was to assess the value of dual-slice helical CT
angiography in detecting deep venous thrombosis in patients in whom acute pulmonary
embolism was suspected and to describe the additional extrathoracic findings. SUBJECTS AND
METHODS: Sixty-five consecutive patients were examined for suspected pulmonary embolism
using helical CT of the chest (2.7-mm collimation; table speed, 7.5 mm/sec; 100-140 mL of
contrast medium injected at a rate of 3 mL/sec) followed by CT of the lower limbs (6.5-mm
collimation; table speed, 10 mm/sec) without any additional contrast medium injection.
Sequential scanning of the abdomen was performed using 10-mm collimation and an interval
of 40 mm. Color Doppler sonography of the lower limbs was done within 24 hr of CT by two
radiologists who were unaware of CT findings. Results of CT venography were compared with
those of Doppler sonography and with phlebography or repeated focalized sonography in
cases of discrepancy. RESULTS: Twenty-two patients had pulmonary embolism revealed on
chest CT. Sixteen patients had a deep venous thrombosis. Thirteen patients with pulmonary
embolism had a deep venous thrombosis. Three patients with deep venous thrombosis had no
pulmonary embolism. Sensitivity and specificity for diagnosing deep venous thrombosis with
CT was 93% and 97%, respectively (kappa = 0.88). Additional extrathoracic findings were
observed in four patients. CONCLUSION: Combined CT venography with dual-slice scanning is
an accurate method to diagnose deep venous thrombosis that may reveal additional imaging
findings in some patients with possible pulmonary embolism.
PMID: 11264105
