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学术急诊医学档案

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  3. 卷 7 编号 1 (2019): Continuous volume
  4. Brief Report

卷 7 编号 1 (2019)

一月 2019

Incidental Findings of Computed Tomography Angiography in Patients Suspected to Pulmonary Embolism; a Brief Report

  • Mustafa Korkut
  • cihan bedel
  • Kürsat Erman
  • Serkan Yüksel

学术急诊医学档案, 卷 7 编号 1 (2019), 1 一月 2019 , 第 e60 页
https://doi.org/10.22037/aaem.v7i1.463 已出版: 2019-10-26

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摘要

Introduction: Computed tomography pulmonary angiography (CTPA)  scans are increasingly used in emergency department (ED). Therefore, the observation of incidental findings (IFs) has also increased. This study aimed to evaluate the frequency of IFs in patients who underwent  CTPA.

Methods: All consecutive patients that underwent CTPA scanning for pulmonary embolism (PE) rule out between January  2017 and June  2018  were analysed. Incidental findings were divided into and reported in three categories: group 1 potentially life-threatening, group 2 required follow up, and group 3 with limited clinical significance.

Results: 151 cases with the mean age of  61.2 ± 17.6 years were studied (54.3% female). PE was documented in 77 cases (50.9%). 448 IFs were detected (3 IFs were found per patient). 60 (13.3%) IFs were classified as group 1, 180 (40.1%) as group 2, and 208 (46.6%) as group 3. Cardiomegaly was the most frequent finding in group 1 (n=32), followed by aortic aneurysm (n=13). In group 2, pleural effusion (n=58) and pneumonia (n=36) were the most frequent incidental findings. Lung structure changes (n=92) and thoracic bone related findings (n=43) were the most common IFs observed in group 3.

Conclusion: IFs were detected in the majority of patients that underwent CTPA. Most of these findings do not require follow-up or treatment. However, more than 50% of cases may require further diagnostic evaluation (40.1%) or immediate treatment (13.3%). 

关键词:
  • Pulmonary embolism
  • tomography
  • incidental findings
  • emergencies
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Korkut M, bedel cihan, Erman K, Yüksel S. Incidental Findings of Computed Tomography Angiography in Patients Suspected to Pulmonary Embolism; a Brief Report. Arch Acad Emerg Med [网际网络]. 2019年10月26日 [见引于 2026年7月8日];7(1):e60. 载于: https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/463
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参考

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Members ATF, Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, et al. 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism: The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC) Endorsed by the European Respiratory Society (ERS). European heart journal. 2014;35(43):3033-80.

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Van der Meer R, Pattynama P. van strjen MJ, van der Berg-Huismans AA, Hartmann IJ, Putter H, de Roos, Huisman MV. Right ventricular dysfunction and pulmonary obstruction index at helical CT: Prediction of clinical outcome during 3-month followup in patients with acute pulmonary embolism. Radiology. 2005;235:798-803.

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Van Strijen M, Bloem J, De Monye W, Kieft G, Pattynama P, VAN DEN BERGâ€HUIJSMANS A, et al. Helical computed tomography and alternative diagnosis in patients with excluded pulmonary embolism. Journal of Thrombosis and Haemostasis. 2005;3(11):2449-56.

Bernard Bagattini S, Bounameaux H, Perneger T, Perrier A. Suspicion of pulmonary embolism in outpatients: nonspecific chest pain is the most frequent alternative diagnosis. Journal of internal medicine. 2004;256(2):153-60.

Hogg K, Brown G, Dunning J, Wright J, Carley S, Foex B, et al. Diagnosis of pulmonary embolism with CT pulmonary angiography: a systematic review. Emergency medicine journal. 2006;23(3):172-8.

Battal B, Karaman B, Gümüş S, Akgün V, Bozlar U, Taşar M. The analysis of non-thromboembolic findings encountered in multidetector computed tomography pulmonary angiography studies in patients with suspected pulmonary embolism. Turkish journal of emergency medicine. 2011;11(1):13-9.

Hall WB, Truitt SG, Scheunemann LP, Shah SA, Rivera MP, Parker LA, et al. The prevalence of clinically relevant incidental findings on chest computed tomographic angiograms ordered to diagnose pulmonary embolism. Archives of internal medicine. 2009;169(21):1961-5.

Perelas A, Dimou A, Saenz A, Rhee JH, Teerapuncharoen K, Rowden A, et al. Incidental findings on computed tomography angiography in patients evaluated for pulmonary embolism. Annals of the American Thoracic Society. 2015;12(5):689-95.

van Es J, Douma RA, Schreuder SM, Middeldorp S, Kamphuisen PW, Gerdes VE, et al. Clinical impact of findings supporting an alternative diagnosis on CT pulmonary angiography in patients with suspected pulmonary embolism. Chest. 2013;144(6):1893-9.

TÜRKVATAN A, Akdur PÖ, AkgüL A, Ölçer T, Cumhur T, Duru E. Prevalence of incidental extracardiac findings on multidetector computed tomographic coronary angiography. Turkiye Klinikleri Journal of Medical Sciences. 2009;29(1):169-75.

Richman PB, Courtney DM, Friese J, Matthews J, Field A, Petri R, et al. Prevalence and significance of nonthromboembolic findings on chest computed tomography angiography performed to rule out pulmonary embolism: a multicenter study of 1,025 emergency department patients. Academic emergency medicine. 2004;11(6):642-7.

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