Utilization patterns and diagnostic yield of 3421 consecutive multidetector row computed tomography pulmonary
Jay H Donohoo1, William W Mayo-Smith, John A Pezzullo
1Brown Medical School, Department of Diagnostic Imaging, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903, USA. donohoo33@yahoo.com
Objective:
To compare examination volume and diagnostic yield of computed tomography (CT) pulmonary angiography (CTPA) and ventilation-perfusion (V/Q) scintigraphy for detection of suspected pulmonary embolism (PE) in emergency department patients.
Methods:
Every CTPA and V/Q scan result for emergency department patients between October 2001 and September 2005 were reviewed. Patients with prior PE and follow-up examinations were excluded.
Results:
A total of 3421 CTPA examinations and 198 V/Q scans met inclusion criteria. Average CTPA examinations completed per month increased 227%, from 33.4 to 109.2 for the first and last 24-month periods, respectively. Ventilation-perfusion scintigraphy volume decreased 80% (from 6.9 to 1.4 per month). Total diagnoses of PE per month increased 89% from 4.0 to 7.5, whereas the percentage of positive CTPA examinations dropped from 9.8% to 6.8%.
Conclusions:
Availability of CT in the emergency department and lower physician thresholds for test utilization have increased the use of CT pulmonary angiography and increased detection of PE.
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