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Using Routine Chest Computed Tomography to Diagnose Pulmonary Embolism
Jason Chan1, Bianca Ho, Kenny Ye
1From the Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY.
Journal of Computer Assisted Tomography
|November 18, 2022
Summary
Routine contrast-enhanced chest CT scans can diagnose unsuspected pulmonary embolism (PE). Over a quarter of scans showed adequate pulmonary artery enhancement, including nearly half of PE-positive cases.
Area of Science:
- Radiology
- Cardiovascular Imaging
- Pulmonary Medicine
Background:
- Pulmonary embolism (PE) diagnosis often relies on specific imaging protocols.
- Routine contrast-enhanced chest CT scans are widely performed for various indications.
Purpose of the Study:
- To evaluate the utility of routine contrast-enhanced chest CT for diagnosing incidental pulmonary embolism (PE).
- To assess the adequacy of pulmonary artery enhancement in these routine scans.
Main Methods:
- Retrospective analysis of 3164 adult contrast-enhanced chest CTs from 2018.
- Measurement of pulmonary artery enhancement using Hounsfield units (HU); adequate enhancement defined as ≥200 HU.
- Statistical analysis including logistic regression to identify factors associated with enhancement and PE presence.
Main Results:
- 28.7% of scans achieved adequate pulmonary artery enhancement (≥200 HU).
- Factors associated with greater enhancement included female sex, older age, and higher contrast volume.
- Pulmonary embolism was detected in 1.8% of cases, with 39.7% of these meeting the adequate enhancement threshold.
Conclusions:
- A significant proportion of routine contrast-enhanced chest CTs provide adequate pulmonary artery enhancement for potential PE diagnosis.
- Nearly half of PE-positive cases demonstrated sufficient enhancement, suggesting the value of reviewing these scans for unsuspected PE.
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