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Can multislice CT alone rule out reliably pulmonary embolism? A prospective study.
Eur J Radiol. 2007 May; 62(2):220-6.EJ

Abstract

PURPOSE

To evaluate the safety of withholding anticoagulation in patients with suspected acute pulmonary embolism after negative multislice computed tomography (MSCT) pulmonary angiography and lower-limb venography.

MATERIALS AND METHODS

A total of 383 consecutive patients with suspected acute pulmonary embolism were prospectively studied. Patients underwent MSCT pulmonary angiography and lower-limb venography, as well as pulmonary scintigraphy and lower-limb ultrasound examination. Patients with negative MSCT results for both pulmonary embolism and venous thrombosis were not administered anticoagulants and were followed up for 6 months to rule out thromboembolism.

RESULTS

At MSCT, 156 patients were positive for pulmonary embolism, venous thrombosis, or both; 224 were negative; and findings were inconclusive in three. False-negatives were five patients with high probability scintigram and two with venous thrombosis detected at US. A total of 184 patients with negative MSCT and without anticoagulation were followed up for 6 months. During this period of time just one recurrence of pulmonary embolism was detected. The negative predictive value of MSCT pulmonary angiography plus lower-limb venography was 95.8% (183/191).

CONCLUSION

MSCT is efficacious in diagnosing pulmonary embolism, with negative predictive values reported in the literature ranging from 94% to 100%. This enables omission of anticoagulation in patients with suspected pulmonary embolism after negative MSCT findings without the need for other diagnostic tests.

Authors+Show Affiliations

Department of Diagnostic Imaging, Hospital Universitario La Fe, Spain. pamies_jos@gva.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17236735

Citation

Guilabert, Jose Pamies, et al. "Can Multislice CT Alone Rule Out Reliably Pulmonary Embolism? a Prospective Study." European Journal of Radiology, vol. 62, no. 2, 2007, pp. 220-6.
Guilabert JP, Manzur DN, Tarrasa MJ, et al. Can multislice CT alone rule out reliably pulmonary embolism? A prospective study. Eur J Radiol. 2007;62(2):220-6.
Guilabert, J. P., Manzur, D. N., Tarrasa, M. J., Llorens, M. L., Braun, P., & Arques, M. P. (2007). Can multislice CT alone rule out reliably pulmonary embolism? A prospective study. European Journal of Radiology, 62(2), 220-6.
Guilabert JP, et al. Can Multislice CT Alone Rule Out Reliably Pulmonary Embolism? a Prospective Study. Eur J Radiol. 2007;62(2):220-6. PubMed PMID: 17236735.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Can multislice CT alone rule out reliably pulmonary embolism? A prospective study. AU - Guilabert,Jose Pamies, AU - Manzur,Dolores Nauffal, AU - Tarrasa,Maria J Torres, AU - Llorens,Maximiliano Lloret, AU - Braun,Petra, AU - Arques,Maria P Bello, Y1 - 2007/01/19/ PY - 2006/09/11/received PY - 2006/11/23/revised PY - 2006/11/24/accepted PY - 2007/1/24/pubmed PY - 2008/5/9/medline PY - 2007/1/24/entrez SP - 220 EP - 6 JF - European journal of radiology JO - Eur J Radiol VL - 62 IS - 2 N2 - PURPOSE: To evaluate the safety of withholding anticoagulation in patients with suspected acute pulmonary embolism after negative multislice computed tomography (MSCT) pulmonary angiography and lower-limb venography. MATERIALS AND METHODS: A total of 383 consecutive patients with suspected acute pulmonary embolism were prospectively studied. Patients underwent MSCT pulmonary angiography and lower-limb venography, as well as pulmonary scintigraphy and lower-limb ultrasound examination. Patients with negative MSCT results for both pulmonary embolism and venous thrombosis were not administered anticoagulants and were followed up for 6 months to rule out thromboembolism. RESULTS: At MSCT, 156 patients were positive for pulmonary embolism, venous thrombosis, or both; 224 were negative; and findings were inconclusive in three. False-negatives were five patients with high probability scintigram and two with venous thrombosis detected at US. A total of 184 patients with negative MSCT and without anticoagulation were followed up for 6 months. During this period of time just one recurrence of pulmonary embolism was detected. The negative predictive value of MSCT pulmonary angiography plus lower-limb venography was 95.8% (183/191). CONCLUSION: MSCT is efficacious in diagnosing pulmonary embolism, with negative predictive values reported in the literature ranging from 94% to 100%. This enables omission of anticoagulation in patients with suspected pulmonary embolism after negative MSCT findings without the need for other diagnostic tests. SN - 0720-048X UR - https://www.unboundmedicine.com/medline/citation/17236735/Can_multislice_CT_alone_rule_out_reliably_pulmonary_embolism_A_prospective_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0720-048X(06)00520-1 DB - PRIME DP - Unbound Medicine ER -