Chest radiographs in acute pulmonary embolism

Area of Science:

• Radiology
• Pulmonology
• Medical Imaging

Background:

• Pulmonary embolism (PE) is a critical condition with high morbidity and mortality.
• Diagnosis of PE is challenging, particularly in regions like Pakistan with limited diagnostic tools and physician awareness.
• This study investigated radiographic findings in acute PE patients at a tertiary care hospital.

Purpose of the Study:

• To determine the presentation of chest radiographs in patients diagnosed with acute pulmonary embolism.
• To analyze the frequency of various radiographic abnormalities in acute PE.
• To evaluate the utility of chest radiography in diagnosing acute PE.

Main Methods:

• Retrospective review of hospital records for acute PE cases (June 2000-June 2004).
• Selection of 50 patients diagnosed with acute PE via Spiral CT scan.
• Independent review of chest radiographs by two chest physicians, with radiologist consultation for discrepancies.

Main Results:

• Chest radiographs were normal in only 18% of acute PE patients.
• Common abnormalities included cardiac enlargement (38%), pulmonary infiltrates (34%), atelectasis (26%), pleural effusion (24%), and pulmonary congestion (24%).
• Less frequent findings were elevated hemi diaphragm (14%), pulmonary artery enlargement (14%), and focal oligemia (8%).

Conclusions:

• Cardiac enlargement is the most frequent radiographic abnormality in acute pulmonary embolism.
• Chest radiography is not a definitive diagnostic tool for acute PE.
• Radiography's primary value lies in excluding other conditions that mimic PE.