Accuracy of the Diagnosis of Subsegmental Pulmonary Embolism Among General Radiologists

Diagnosis and treatment of subsegmental pulmonary embolism (SSPE) are challenging. Contrary to segmental pulmonary emboli (PE), little is known about the accuracy of the diagnosis of SSPE. We aimed to assess the accuracy of SSPE in our retrospective cohort study. Patients with isolated SSPE were included. Concurrent segmental PE or deep venous thrombosis (DVT) were considered an exclusion criteria. Another radiologist reviewed each CTA. A total of 43 patients with SSPE were identified. Forty patients (93%) received therapeutic anticoagulation. The average duration of anticoagulation therapy was four months. Another radiologist's review of the CTA on admission revealed a discordant diagnosis: 13 out of 43 (30%) cases were reported negative for SSPE. One case was reported for segmental PE. As a conclusion, the accuracy of the diagnosis of SSPE is low as the discordance rate by different radiologists is high. More studies are needed to establish the diagnosis and guide treatment of SSPE.