[Thoracic x-ray computed tomography and unexpected diagnosis of pulmonary embolism]

The gold standard for the diagnosis of pulmonary embolism is still pulmonary angiography. Chest CT scan with injection of contrast medium can demonstrate a pulmonary embolism. In some cases, CT may discover a non suspected embolism. The aim of this retrospective study was to point out when an injection of contrast medium is necessary during CT scan of the chest to avoid to overlook and unsuspected pulmonary embolism. Ten cases of suspected pulmonary embolism on CT were retrospectively studied. Two cases were false positives. Our method did not allow to study false negatives. Out of the eight true positive cases, four were not suspected by the physician and in all cases, the exam record was not really clear. At the end of this study and referring to the literature, we conclude that CT scan of the chest can be performed with injection of contrast medium if a pulmonary embolism is one of the eventual diagnosis when an other suspected affection is an indication for CT.