Technical Challenges on CT Pulmonary Angiogram: Our Data

Abstract

Purpose: This study aims to evaluate the role of imaging modalities, especially CTPA in diagnosing pulmonary embolism and briefly summarize PE distribution according to age and gender.Material and methods: Data of patients were collected at the "Shefqet Ndroqi" University Hospital, Department of Imaging, Tirana, Albania; during one year period, January 2017 – January 2018.Based on clinical and laboratory data, the study included 300 patients with suspected pulmonary embolisms; 53% were women and 47% were men with an average age of 64.2 years. The patients underwent this diagnostic protocol: physical examination, laboratory examination, and imaging diagnosis (radiography, CTA, MN). Chest X-ray (standing position, PA projection) was performed in all patients included in the study; 98% of patients underwent angio-CT examination, after injection of 50-65 mL of contrast media, Ultravist 370. Nuclear medicine was performed in 2% of patients after injection of 5mCi Tc-99m labeled with MAA.Results: The study shows that pulmonary embolism was found in 17.7 % of the total sample population (54 % of women and 46% of men).  And the group aged 61-70 years old was more affected. CTPA examination data resulted in the final diagnosis and exclusion of PE in 98% of cases: 17.4 % positive for PE; 81.2 % negative for PE and 1.4 % indeterminate due to poor opacification of pulmonary arteries. Perfusion defect was found in two cases.Conclusion: CTPA is the imaging modality of choice in the diagnosis of PE, allowing direct visualization of the thrombus in the vascular lumen by determining the optimal time of pulmonary arteries opacification.

Keywords: pulmonary embolism, CTPA, MN, radiography

DOI: 10.7176/JHMN/110-03

Publication date:August 31^st 2023