| Beyond the pulmonary arteries: alternative diagnoses in children with MDCT pulmonary angiography negative for pulmonary embolism. | |
| | |
MedLine Citation:
|
PMID: 19696306 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: A potential advantage of pulmonary CT angiography (CTA) is its ability to show alternative diagnoses in patients without evidence of pulmonary embolism (PE), but the frequency and spectrum of alternative diagnoses have yet to be determined in the pediatric population. Our purpose was to determine the frequency and types of alternative diagnoses identified in children with clinically suspected but excluded PE. MATERIALS AND METHODS: We used our hospital information system to identify all consecutive pediatric patients (< 18 years old) with clinically suspected PE who underwent pulmonary CTA from July 2004 to March 2008. Two experienced pediatric radiologists reviewed by consensus a series of 96 consecutive diagnostic-quality pulmonary CTA studies without evidence of PE from 89 patients. Each study was systematically reviewed by consensus for a possible alternative diagnosis in the lungs, mediastinum, central airways, cardiovascular system, pleura, and skeleton. RESULTS: The study population consisted of 89 children (28 boys and 61 girls; mean age 13.4 +/- 4.7 years; range, 2 months-18 years; 34 inpatients, 62 outpatients) who underwent a total of 96 pulmonary CTA studies without evidence of PE. Thirty-nine (41%) of 96 pulmonary CTA studies were normal. Alternative diagnoses were identified for each of the remaining 57 (59%) studies, including: pneumonia (n = 22), atelectasis (n = 22), malignancy (n = 3), congenital heart disease (n = 2), pulmonary hypertension (n = 2), pericardial effusion (n = 2), pulmonary nodules (n = 1), rib fractures (n = 1), right atrial thrombus (n = 1), and fat embolism (n = 1). Seventeen patients showed pleural effusions that were associated with coexisting pneumonia (n = 8), atelectasis (n = 8), or rib fractures (n = 1). CONCLUSION: Among children with clinically suspected but excluded PE, pulmonary CTA frequently shows positive findings. Although pneumonia and atelectasis are most common, a variety of other alternative diagnoses may be detected throughout the thorax. |
| | |
Authors:
|
Edward Y Lee; Supika Kritsaneepaiboon; David Zurakowski; Claudia Martinez Rios Arellano; Keith J Strauss; Phillip M Boiselle |
Related Documents
:
|
10744146 - Value of chest x-ray combined with perfusion scan versus ventilation/perfusion scan in ... 23328766 - Importance of technical preparation of intraarterial shunts to prevent iatrogenic arter... 3238666 - Thoraco-pleural actinomycosis presenting like diffuse pulmonary embolism. 17924216 - Pulmonary cement embolism: a complication of percutaneous vertebroplasty. 21699546 - Detection of altered extracellular matrix in surface layers of unstable carotid plaque:... 18664026 - Is there an association between coronary atherosclerosis and airway responsiveness? |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: AJR. American journal of roentgenology Volume: 193 ISSN: 1546-3141 ISO Abbreviation: - Publication Date: 2009 Sep |
Date Detail:
|
Created Date: 2009-08-21 Completed Date: 2009-09-29 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 7708173 Medline TA: AJR Am J Roentgenol Country: United States |
Other Details:
|
Languages: eng Pagination: 888-94 Citation Subset: AIM; IM |
Affiliation:
|
Department of Radiology, Children's Hospital Boston and Harvard Medical School, 300 Longwood Ave., Boston, MA 02115, USA. Edward.Lee@childrens.harvard.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Angiography / methods* Child Child, Preschool Contrast Media Diagnosis, Differential Female Humans Infant Lung Diseases / radiography* Male Pulmonary Artery / radiography Pulmonary Embolism / radiography Retrospective Studies Tomography, X-Ray Computed / methods* |
| Chemical | |
Reg. No./Substance:
|
0/Contrast Media |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Toxic and acquired metabolic encephalopathies: MRI appearance.
Next Document: Ulcerlike projections developing in noncommunicating aortic dissections: CT findings and natural his...