Unenhanced computed tomography scans identified pulmonary emboli in 21 of 51 (41.2%) positive cases, allowing characterization of clots as hyperattenuating, hypoattenuating, or mixed.
Observational (n=140)
Can unenhanced computed tomography (CT) scans detect and characterize emboli in patients with suspected acute pulmonary embolism?
Unenhanced CT scans can identify and characterize clots in a substantial proportion of patients with acute pulmonary embolism, particularly in cases of central thromboembolism.
OBJECTIVE: To evaluate the percentage of cases in which emboli can be detected in unenhanced scans and to identify the cases in which they appear hyperattenuating or hypoattenuating in comparison to the circulating blood. METHOD: An angio-computed tomography (CT) scan was performed before and after contrast injection in 140 consecutive patients after clinical suspicion of pulmonary embolism. A radiologist analyzed the examination results thus obtained. The enhanced scan was analyzed first, and after detecting the thrombus, the unenhanced scan was evaluated. RESULTS: Fifty-one examinations were positive for a pulmonary embolism; in 21 cases, it was possible to identify the embolus even in the unenhanced scans. In 10 cases, the clots were hyperattenuating in comparison to the circulating blood; in 5 cases, they were hypoattenuating; and in 6 cases, they were mixed hyper-hypoattenuating. CONCLUSION: In a relatively high percentage of cases, particularly those of central thromboembolism, it is possible to identify and characterize the clots even in unenhanced scans.
Cobelli et al. (2005) conducted an observational in Acute pulmonary embolism (n=140). Unenhanced computed tomography (CT) scan vs. Enhanced CT scan (with contrast injection) was evaluated on Percentage of cases in which emboli can be detected in unenhanced scans. Unenhanced computed tomography scans identified pulmonary emboli in 21 of 51 (41.2%) positive cases, allowing characterization of clots as hyperattenuating, hypoattenuating, or mixed.
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