Emergency CTPA performed in one year: clinical results

Purpose: To review the CTPA scans performed on patients with clinical suspicion of acute PE in one year, and assess final diagnosis and presence of unexpected findings.Methods and Materials: All the emergency CTPA scans performed in 12 months (January-December 2010) were reviewed and evaluated for the presence of pulmonary embolism and/or other thoracic findings. The presence of PE was correlated to D-Dimer levels. When the abdomenwas scanned to search for thrombosis, the presence of thrombosis and/or other abdominal findings was assessed.Results: Over 12 months, 239 emergency CTPA scans were performed (128F/121M, mean age 67,1 years). 97 % patients had D-Dimer >500ng/dl. 74 patients (31%) were diagnosed with PE: 48/74 involving the pulmonary trunk, the main pulmonary arteries or lobar arteries. 73/74 patients had D-Dimer >500ng/dl. In 51/74 patients the abdomen wasscanned: 5 cases of DVT were observed. Collateral findings in these 74 patients with PE included pleural effusion (27/74), parenchymalconsolidation (15/74) and tumours (7/74). 165 scans were negative for PE: 75/165 patients had no significant findings at CT, while 90 had pleural effusion (66) and/or parenchymal consolidation (36) and/or tumours (10).160/165 patients had D-Dimer >500ng/dl. In 72/165 the abdomen wasscanned: 8 cases of DVT were observed.Conclusion: Even in a population with a relatively high prevalence of PE, most of the patients who undergo CTPA for clinically suspected PE will not have PE. Scanning the abdomen to search for DVT shows a DVT prevalence around 10 % both in patients with and without PE.