New insights into the natural history of thrombo-embolic disease provided by imaging and disease quantification (original) (raw)
Purpose: To assess the change in practice and resulting diagnostic outcome in the radiological investigation of pulmonary embolism since the introduction of helical CTPA in a large teaching hospital. Methods and Materials: A retrospective review was undertaken of all radiological investigations performed over a 6-year period before and after the introduction of CTPA (protocols 1 and 2, respectively) as an integral part of the imaging protocol in the investigation of clinically suspected PE. The total numbers and results of all investigations are assessed for each protocol. Results: A substantive increase in both the total number of patients and the number of investigations performed for the investigation of PE since the introduction of CTPA occurred. Five hundred and twenty-six patients underwent 617 investigations performed in 1995/1996 with 760 patients undergoing 805 in 2001/2002. There was a significant decrease in the number of investigations per patient, 1.17 in 1995/1996 versus 1.06 in 2001/2002. Primary investigation showed a significant decrease in indeterminate examinations from 25.7% to 8.5% and an increase in positive results for pulmonary embolism from 18% to 24%. Conclusion: In the study population there was a significant increase in the number of patients being investigated for PE, with a decrease in both the number of non-diagnostic investigations and the total investigations per patient since the introduction of helical CTPA. This is probably due to the ready availability of a new imaging technique and Insights into VTE John T Murchison 15 physicians awareness, that CTPA has significantly improved specificity, which encourages the referral of patients for investigation.
Loading Preview
Sorry, preview is currently unavailable. You can download the paper by clicking the button above.