Computed tomographic pulmonary angiography: Difference between revisions
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In [[diagnostic imaging]], '''computed tomographic pulmonary angiography''', also called '''CT pulmonary angiography''' ('''CTPA'''), is a form of [[x-ray computed tomography]] for examining the pulmonary vessels.<ref name="pmid18165667">{{cite journal |author=Anderson DR, Kahn SR, Rodger MA, ''et al'' |title=Computed tomographic pulmonary angiography vs ventilation-perfusion lung scanning in patients with suspected pulmonary embolism: a randomized controlled trial |journal=JAMA : the journal of the American Medical Association |volume=298 |issue=23 |pages=2743–53 |year=2007 |month=December |pmid=18165667 |doi=10.1001/jama.298.23.2743 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=18165667 |issn=}}</ref> | In [[diagnostic imaging]], '''computed tomographic pulmonary angiography''', also called '''CT pulmonary angiography''' ('''CTPA'''), is a form of [[x-ray computed tomography]] for examining the pulmonary vessels.<ref name="pmid18165667">{{cite journal |author=Anderson DR, Kahn SR, Rodger MA, ''et al'' |title=Computed tomographic pulmonary angiography vs ventilation-perfusion lung scanning in patients with suspected pulmonary embolism: a randomized controlled trial |journal=JAMA : the journal of the American Medical Association |volume=298 |issue=23 |pages=2743–53 |year=2007 |month=December |pmid=18165667 |doi=10.1001/jama.298.23.2743 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=18165667 |issn=}}</ref> | ||
Introduction of computed tomographic pulmonary angiography may have led to overdiagnosis of [[pulmonary embolism]].<ref name="pmid21555660">{{cite journal| author=Wiener RS, Schwartz LM, Woloshin S| title=Time trends in pulmonary embolism in the United States: evidence of overdiagnosis. | journal=Arch Intern Med | year= 2011 | volume= 171 | issue= 9 | pages= 831-7 | pmid=21555660 | doi=10.1001/archinternmed.2011.178 | pmc=PMC3140219 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21555660 }} </ref> | |||
==Pulmonary embolism== | ==Pulmonary embolism== | ||
Revision as of 20:35, 21 June 2012
In diagnostic imaging, computed tomographic pulmonary angiography, also called CT pulmonary angiography (CTPA), is a form of x-ray computed tomography for examining the pulmonary vessels.[1]
Introduction of computed tomographic pulmonary angiography may have led to overdiagnosis of pulmonary embolism.[2]
Pulmonary embolism
- Role in diagnosis
Assessing the accuracy of CT pulmonary angiography is hindered by the rapid changes in the number of rows of detectors available in multidetector CT (MDCT) machines.[3] The PIOPED II study used a mixture of 4 slice and 16 slice scanners and reported a sensitivity of 83% and a specificity of 96%. This study noted that additional testing is necessary when the clinical probability is inconsistent with the imaging results.[4]
- Role in Prognosis
Two systematic reviews[5][6] and two more recent randomized controlled trials[7][1] have studied prognosis after a negative CTPA.
References
- ↑ 1.0 1.1 Anderson DR, Kahn SR, Rodger MA, et al (December 2007). "Computed tomographic pulmonary angiography vs ventilation-perfusion lung scanning in patients with suspected pulmonary embolism: a randomized controlled trial". JAMA : the journal of the American Medical Association 298 (23): 2743–53. DOI:10.1001/jama.298.23.2743. PMID 18165667. Research Blogging.
Cite error: Invalid
<ref>tag; name "pmid18165667" defined multiple times with different content - ↑ Wiener RS, Schwartz LM, Woloshin S (2011). "Time trends in pulmonary embolism in the United States: evidence of overdiagnosis.". Arch Intern Med 171 (9): 831-7. DOI:10.1001/archinternmed.2011.178. PMID 21555660. PMC PMC3140219. Research Blogging.
- ↑ Schaefer-Prokop C, Prokop M (2005). "MDCT for the diagnosis of acute pulmonary embolism". European radiology 15 Suppl 4: D37-41. PMID 16479644. [e]
- ↑ Stein PD, Fowler SE, Goodman LR, et al (2006). "Multidetector computed tomography for acute pulmonary embolism". N. Engl. J. Med. 354 (22): 2317-27. DOI:10.1056/NEJMoa052367. PMID 16738268. Research Blogging.
- ↑ Quiroz R, Kucher N, Zou KH, et al (April 2005). "Clinical validity of a negative computed tomography scan in patients with suspected pulmonary embolism: a systematic review". JAMA : the journal of the American Medical Association 293 (16): 2012–7. DOI:10.1001/jama.293.16.2012. PMID 15855435. Research Blogging.
- ↑ Moores LK, Jackson WL, Shorr AF, Jackson JL (December 2004). "Meta-analysis: outcomes in patients with suspected pulmonary embolism managed with computed tomographic pulmonary angiography". Annals of internal medicine 141 (11): 866–74. PMID 15583229. [e]
- ↑ Righini M, Le Gal G, Aujesky D, et al (April 2008). "Diagnosis of pulmonary embolism by multidetector CT alone or combined with venous ultrasonography of the leg: a randomised non-inferiority trial". Lancet 371 (9621): 1343–52. DOI:10.1016/S0140-6736(08)60594-2. PMID 18424324. Research Blogging.