CT pulmonary angiogram quality comparison between early and later pregnancy

Area of Science:

• Radiology
• Obstetrics
• Cardiovascular Imaging

Background:

• Pregnancy elevates the risk of thromboembolic disease, necessitating accurate diagnostic imaging.
• Computed Tomography Pulmonary Angiogram (CTPA) is a key tool for diagnosing pulmonary embolism (PE).
• Suboptimal CTPA scans are more frequent in pregnant patients due to physiological changes.

Purpose of the Study:

• To investigate if the risk of suboptimal CTPA scans varies across different stages of pregnancy.
• To compare CTPA scan quality in pregnant patients versus non-pregnant controls.

Main Methods:

• Retrospective analysis of CTPA scans in pregnant patients (2008-2014).
• Comparison of pulmonary artery attenuation (Hounsfield units - HU) between pregnant patients and controls.
• Defined 200 HU as the threshold for adequate scan opacification.

Main Results:

• Early pregnancy scans (≤13 weeks) demonstrated significantly higher arterial attenuation than later pregnancy scans (p < 0.05).
• Fewer suboptimal opacified arteries were observed in early pregnancy (11.1%) and controls (5.7%) compared to later pregnancy (33.3%) (p < 0.01).
• Early pregnancy scans showed opacification comparable to non-pregnant controls.

Conclusions:

• CTPA scans are technically more successful in early pregnancy than in later stages.
• Early pregnancy CTPA results are similar to those in non-pregnant individuals.
• Findings suggest a potential shift in diagnostic strategies for suspected PE in pregnant patients.