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Missed pulmonary embolism on abdominal CT
Kun Young Lim1, Seth J Kligerman, Cheng Ting Lin
11 Department of Radiology, National Cancer Center, Goyang-si Gyeonggi-do, Republic of Korea.
AJR. American Journal of Roentgenology
|March 26, 2014
Summary
Pulmonary emboli (PE) are often missed on abdominal CT scans. Radiologists should carefully examine the lower pulmonary arteries on these scans to improve diagnosis.
Area of Science:
- Radiology
- Pulmonary Medicine
- Diagnostic Imaging
Background:
- Pulmonary embolism (PE) is a significant cause of morbidity and mortality.
- Abdominal CT scans are frequently performed for various clinical indications.
Purpose of the Study:
- To evaluate missed pulmonary emboli (PE) incidentally found on abdominal CT scans.
- To characterize the features of these missed PEs and their clinical context.
Main Methods:
- Retrospective review of chest CT scans and contrast-enhanced abdominal CT scans over 12 months.
- Three radiologists assessed abdominal CTs for evidence of missed PE.
- Clinical data was extracted from electronic medical records.
Main Results:
- Eighteen patients with missed PE on abdominal CT were identified.
- In 38.9% of cases, the PE was previously undiagnosed.
- Missed PEs were predominantly segmental, with some involving lobar vessels.
Conclusions:
- Pulmonary emboli can be incidentally detected on abdominal CT scans.
- Routine interpretation of contrast-enhanced abdominal CTs should include careful evaluation of the lower pulmonary vasculature.
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