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Reduced Z-axis Coverage in Multi-Detector-Row CT Pulmonary Angiography Decreases Radiation Dose and Diagnostic Accuracy of Alternative Diseases.
MedLine Citation:
PMID:  24258464     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objectives:to investigate the effect of a two-thirds reduction of the scanned length (i.e. 10-cm) on diagnosis of both pulmonary embolism (PE) and alternative diseases.Methods:Two hundred and forty seven consecutive patients suspected of acute PE had a CTPA of the thorax (standard length) (L). Based on this acquisition, a second set of images was created to obtain a scan length of 10 cm caudally to the aortic arch (l). Images were anonymized, randomized, and interpreted by two independent readers. Enhancement quality, presence of PE, and possible alternative and/or complementary diagnoses were recorded. A McNemar exact test investigated differences in discrepancies between readers and between scan lengths.Results:Fifty-seven (23%) patients had an acute PE. Among l sets, PE was missed by both readers in one (1.8%) patient because the unique clot was localized in a subsegmental artery out of the 10 cm range. There were discrepancies between L and l sets in nine (3.6%) and 11 (4.5%) patients, by reader 1 and 2 (p=0.820), respectively. Discrepancies between readers of L sets and those between both sets were not different regardless of the reader (p>0.99). There were discrepancies between both sets for alternative and/or complementary diagnoses in 43 (17.2%) patients.Conclusion:Although its performance in diagnosing PE is maintained, CTPA should not be restricted to a range of 10 cm centred the pulmonary hilum because alternative and/or complementary diagnoses could be missed.
Authors:
Nicolas Michalakis; Caroline Keyzer; Viviane De Maertelaer; Denis Tack; Pierre Alain Gevenois
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-11-20
Journal Detail:
Title:  The British journal of radiology     Volume:  -     ISSN:  1748-880X     ISO Abbreviation:  Br J Radiol     Publication Date:  2013 Nov 
Date Detail:
Created Date:  2013-11-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0373125     Medline TA:  Br J Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the Department of Radiology, Hôpital Erasme, Université libre de Bruxelles, route de Lennik 808, B 1070 Brussels, Belgium.
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