Unsuspected pulmonary embolism was found in 5.7% of inpatients undergoing contrast-enhanced MDCT of the thorax, with incidence increasing significantly in older patients (p<0.001).
Observational (n=487)
Unsuspected pulmonary embolism is a relatively common incidental finding on contrast-enhanced chest MDCT, especially in older inpatients, and is frequently missed on initial review.
AIM: To quantify the incidence of unsuspected pulmonary emboli (PE) in an unselected inpatient population undergoing contrast enhanced multidetector CT (MDCT) scanning of the thorax and to assess aetiological factors in their development. METHODS: All inpatients undergoing MDCT scanning of the thorax over a 10 month period were prospectively identified. Patients with previous or suspected current PE were excluded. CT scans were reviewed and the degree of contrast enhancement and presence of PE recorded. Where PE was found, the level of the most proximal thrombus was identified. Patient age, length of admission, slice scan thickness and clinical indication were noted. RESULTS: 547 inpatients who had undergone MDCT scanning were identified. Following exclusions 487 remained, 28 of whom (5.7%) had PE. Unsuspected PE was more common with increasing age, occurring in 9.2% (20/218) of all patients over 70 years and 16.7% (11/66) of those over 80 years (p30% are missed on initial review. PE should be routinely sought in all contrast enhanced MDCT scans of the chest, irrespective of the indication for the CT scan.
Ritchie et al. (2006) conducted an observational in Unsuspected pulmonary embolism (n=487). Contrast enhanced multidetector CT (MDCT) scanning was evaluated on Incidence of unsuspected pulmonary emboli (PE). Unsuspected pulmonary embolism was found in 5.7% of inpatients undergoing contrast-enhanced MDCT of the thorax, with incidence increasing significantly in older patients (p<0.001).