pulmonary angiography vs spiral ct

The angiograms were reviewed on a workstation using a cine loop. HHS Of these, 40 were 4.2 mm in diameter and 46 were 3.8 mm in diameter. Summary. 2C —Acute pulmonary embolism (PE) in 78-year-old woman (same patient as shown in Figs. This phantom study investigated the effects of patient shielding and scan length reduction on the fetal and maternal ionising radiation dose from CTPA. Eur J Radiol. CT and angiographic findings were negative for PE in 25 patients; one patient had false-negative CT findings. A double-lumen (18-gauge) catheter was introduced into the left internal jugular vein for measurement of central venous pressure and the administration of intravenous fluids and drugs as required. 2016 Mar-Apr;49(2):75-8. doi: 10.1590/0100-3984.2014.0115. There was no difference between readers for accuracy of detection of emboli for CT3 (p = 0.08), CT1 (p = 1.00), or angiography (p = 0.39). In this study angiography failed to detect eight emboli that were correctly identified by CT3 and eight emboli that were correctly identified by CT1, and these were assigned as false positives for spiral CT (38% of all the false positives attributed to CT3 and CT1). Fleiss, J. L. 1981. Results from this study show that for emboli that are equivalent in size (3.8 to 4.2 mm) to human subsegmental pulmonary vessels (13), angiography has a sensitivity of only 87% and a positive predictive value of 88%. CT angiography may also cost less than catheter angiography. The two emboli lost from the cast as well as the five found outside the scanned volume were not included in the analysis. CT angiography of the heart is a useful way of detecting blocked coronary arteries. IEEE Trans Med Imaging. Although CT1 was more sensitive than CT3, its positive predictive value was less than CT3 or angiography owing to a greater prevalence of false positives. Click to see any corrections or updates and to confirm this is the authentic version of record. The amount and rate of injection of contrast was calculated, according to the formula used for humans in our institution, and adjusted for the pig's weight (0.57 ml/kg and 0.28 ml/kg/s, respectively). Clin Med (Lond). By continuing to browse CT demonstrated central PE in two patients with normal V-P scans. The introduction of multidetector scanners will minimize this potential limitation. Ninety-five percent confidence intervals for sensitivity and positive predictive values were calculated for each size of emboli. The pigs were intubated, and ventilated using a tidal volume of 10 to 12 ml/kg and a rate of approximately 12 breaths/ min. Results: (C ) Pulmonary angiogram (25° right anterior oblique) shows absent filling of the artery caused by embolus 2, and a cutoff due to embolus 3. Sensitivity and 95% confidence intervals for 3 mm and 1 mm collimation CT and angiography, respectively, were: 82% (73 to 88%), 87% (79 to 93%), 87% (79 to 93%) (p = 0.42). Garg K, Welsh CH, Feyerabend AJ, Subber SW, Russ PD, Johnston RJ, Durham JD, Lynch DA. There was no difference between spiral CT and angiography for detection of subsegmental-sized pulmonary emboli. Specifications were: CT3: pitch 2, 320 mA, 1 s rotation time and 120 kVp, preparation delay of 13 ± 3.5 s, contrast volume 72 ± 3 ml/run at a rate of 1.7 ± 0.1 ml/s. The sensitivity of CT angiography in the diagnosis or exclusion of PE in all pulmonary arteries (to the level of the subsegmental pulmonary arteries) was 0.68 on the basis of a specificity of 0.91. Anesthesia was maintained by inhalation of 1 to 2% isoflurane (Abott, Montreal, PQ, Canada). 7 In 1992, different filling defect patterns on spiral volumetric CT and pulmonary angiography used for the diagnosis of PE were compared for the first time. We conclude that spiral CT is comparable to angiography for detection of pulmonary emboli. No radiation remains in a patient's body after a CT examination. Ten emboli were depicted only on CT scans, whereas seven emboli were identified only on angiograms because of inadequate depiction of the pulmonary arteries in the plane of the CT scans (n = 5) or because of misinterpretation of CT findings (n = 2). The average rate of injection was 14 ml/ s, and the total dose was 28 ml. Methods: A total of 83 patients with suspected pulmonary embolism were examined using V/Q lung scintigraphy in SPECT technique as well as 4-slice spiral CT. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Changing practice patterns in the workup of pulmonary embolism. This site uses cookies. J Orthop Surg Res. Predictive value of 16-slice multidetector spiral computed tomography to detect significant obstructive coronary artery disease in patients at high risk for coronary artery disease: patient- versus segment-based analysis. We conclude that spiral CT is comparable to angiography for detection of pulmonary emboli. Spiral computed tomographic (CT) angiography of the pulmonary circulation has emerged recently as a potential useful diagnostic method for the evaluation of the pulmonary circulation. Remy-Jardin M, Remy J, Deschildre F, Artaud D, Beregi JP, Hossein-Foucher C, Marchandise X, Duhamel A. Radiology, (3):699-706 MED: 8756918 A prospective study was performed in 75 patients who were evaluated with spiral CT and pulmonary angiography of each lung to detect central PE; 25 of the patients also underwent ventilation-perfusion (V-P) scanning. Victor F. Tapson, MD, FCCP, Duke University Medical Center March, 2005 Review: Moores LK, Jackson WL Jr, Shorr AF, Jackson JL.Meta-Analysis: Outcomes in Patients with Suspected Pulmonary Embolism Managed with Computed Tomographic Pulmonary Angiography. FissureNet: A Deep Learning Approach For Pulmonary Fissure Detection in CT Images. Table 1. It is impossible to calculate the specificity (percentage of true negatives) because it is not possible to count the total number of unaffected arteries. Contemporary diagnostic approaches to acute pulmonary emboli. (B) Posterior view of cast of right lung clearly showing embolus 1. 2003 Jul;13(7):1501-7. doi: 10.1007/s00330-002-1709-3. There was no difference in positive predictive values between CT3, CT1, and angiography (p = 0.25, p = 0.23, respectively). Imaging results of spiral CT angiography were compared and validated against a normal perfusion scan in 40 patients, a high-probability scintigram in 53 patients, and a pulmonary angiogram in 56 patients. There are two principal approaches for performing a CTPA of high diagnostic quality: Pulmonary embolism: validation of spiral CT angiography in 149 patients. Prolonged resuscitation of metabolic acidosis after trauma is associated with more complications. Michiels JJ, Schroyens W, De Backer W, van der Planken M, Hoogsteden H, Pattynama PM. Pancuronium bromide (0.15 mg/kg) was administered 1 min before the injection of nonionic contrast medium (Optiray 320) via the brachial vein cannula.  |  We studied 16 anesthetized, juvenile pigs and injected colored methacrylate beads (3.8 mm, small; 4.2 mm, large) via the jugular vein. These were assigned as false negatives for spiral CT (52% of all the false negatives attributed to CT3 and CT1). The lungs were inflated slowly (25 to 30 cm water) and allowed to deflate to approximately 12 cm water positive end-expiratory pressure (PEEP). Spiral computed tomography versus pulmonary angiography in the diagnosis of acute massive pulmonary embolism.

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