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Related Concept Videos

Computed Tomography01:10

Computed Tomography

Tomography refers to imaging by sections. Computed tomography (CT) is a non-invasive imaging technique that uses computers to analyze several cross-sectional X-rays to reveal minute details about structures in the body.
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Radiological Investigation II: MRI and Ventilation Perfusion Scan01:30

Radiological Investigation II: MRI and Ventilation Perfusion Scan

Description
Magnetic Resonance Imaging (MRI) and Ventilation Perfusion Scans are two radiological investigations that offer detailed diagnostic images of the body, particularly lung structures.
MRI
MRI uses magnetic fields and radiofrequency signals to distinguish between normal and abnormal tissues. This technology provides a more detailed diagnostic image than CT scans, enabling it to characterize pulmonary nodules, stage bronchogenic carcinoma, and evaluate inflammatory activity in...
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Radiological Investigation III: Pulmonary Angiogram and PET Scan

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Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
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Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
Imaging Studies III: Computed Tomography01:27

Imaging Studies III: Computed Tomography

DefinitionComputed Tomography (CT) of the genitourinary (GU) tract is a non-invasive imaging modality that utilizes X-rays and computer processing to generate detailed cross-sectional images of the urinary system, encompassing the kidneys, ureters, bladder, and adjacent structures such as the adrenal glands.PurposeCT scans of the GU tract serve several diagnostic and therapeutic purposes, including:Diagnosis of Urinary Tract Diseases: Detects kidney stones, tumors, cysts, and congenital...

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Multidetector-row computed tomography in suspected pulmonary embolism.

Arnaud Perrier1, Pierre-Marie Roy, Olivier Sanchez

  • 1Service of General Internal Medicine, Geneva Faculty of Medicine and Geneva University Hospital, Geneva, Switzerland. arnaud.perrier@medecine.unige.ch

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Area of Science:

  • Medical Imaging
  • Diagnostic Medicine
  • Cardiovascular Diseases

Background:

  • Single-detector-row CT has low sensitivity for pulmonary embolism (PE).
  • Current protocols often require combining CT with lower-limb ultrasonography.
  • Evaluating alternative diagnostic strategies is crucial for efficient PE diagnosis.

Purpose of the Study:

  • To assess the safety and efficacy of using D-dimer testing and multidetector-row CT (MDCT) to rule out PE.
  • To determine if lower-limb ultrasonography can be omitted in the diagnostic workup for PE.

Main Methods:

  • A sequential diagnostic strategy involving D-dimer and MDCT was applied to 756 patients with suspected PE.
  • Patients were managed in emergency departments across three teaching hospitals.
  • A three-month follow-up was conducted for all participants.

Main Results:

  • Pulmonary embolism was detected in 26% of patients.
  • In patients without high clinical probability, a negative D-dimer assay and uneventful follow-up occurred in 34%.
  • The overall three-month risk of thromboembolism was 1.5% when using only D-dimer and MDCT, suggesting a safe alternative to ultrasonography.

Conclusions:

  • A diagnostic strategy combining D-dimer testing and MDCT appears to safely rule out pulmonary embolism.
  • This approach may reduce the need for lower-limb ultrasonography.
  • Further outcome studies are recommended before widespread clinical adoption.