Related Experiment Video
Updated: Jul 17, 2026
02:09
Multi-modal Pulmonary Imaging: Using Complementary Information from CT and Hyperpolarized 129Xe MRI to Evaluate Lung Structure-Function
Published on: April 12, 2024
Can multislice CT alone rule out reliably pulmonary embolism? A prospective study
Jose Pamies Guilabert1, Dolores Nauffal Manzur, Maria J Torres Tarrasa
1Department of Diagnostic Imaging, Hospital Universitario La Fe, Spain. pamies_jos@gva.es
European Journal of Radiology
|January 24, 2007
Summary
Withholding anticoagulation is safe for patients with suspected acute pulmonary embolism if multislice computed tomography (MSCT) pulmonary angiography is negative. This diagnostic approach effectively rules out thromboembolism in most cases.
Area of Science:
- Radiology
- Cardiology
- Vascular Medicine
Background:
- Acute pulmonary embolism (PE) is a life-threatening condition.
- Diagnosis often involves advanced imaging and anticoagulation initiation.
- The safety of withholding anticoagulation based on negative imaging requires evaluation.
Purpose of the Study:
- To assess the safety of omitting anticoagulation in patients with suspected PE.
- To determine the efficacy of multislice computed tomography (MSCT) pulmonary angiography in ruling out PE.
- To evaluate the negative predictive value of MSCT in this context.
Main Methods:
- Prospective study of 383 patients with suspected PE.
- Dual imaging: MSCT pulmonary angiography and lower-limb venography.
- Follow-up of 184 patients without anticoagulation for 6 months.
Main Results:
- MSCT identified PE or venous thrombosis in 156 patients; 224 had negative results.
- One PE recurrence occurred in 184 patients managed without anticoagulation.
- Negative predictive value of MSCT pulmonary angiography plus lower-limb venography was 95.8%.
Conclusions:
- MSCT is highly effective in diagnosing PE.
- Negative MSCT findings allow for safe omission of anticoagulation.
- This strategy avoids the need for additional diagnostic tests in suspected PE.
Related Concept Videos
01:29Pulmonary 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...
01:28Imaging Studies for Cardiovascular System V: CT
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...
01:13Radiological Investigation III: Pulmonary Angiogram and PET Scan
Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
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...
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...
01:19Pulmonary Embolism I: Introduction
A blood clot, or thrombus, is a semi-solid mass composed of fibrin, platelets, and red blood cells. When it forms within a vessel, it can obstruct blood flow, known as thrombosis. If part of the clot detaches, it becomes an embolus that can travel and block distant vessels. When this occurs in the pulmonary arteries, it causes a condition known as pulmonary embolism (PE).Origin and ImpactMost often, the embolus originates from a thrombus in the deep veins of the lower limbs, a condition called...
01:29Pulmonary Embolism I: Introduction
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
01:20Imaging Studies for Cardiovascular System III: X-Ray
The most common cardiovascular diagnostic test is an X-ray. It produces images of the heart, blood vessels, and adjacent structures.
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...