Impact of CT venography added to CT pulmonary angiography for the detection of deep venous thrombosis and relevant incidental CT findings.

Details

Serval ID
serval:BIB_4F00E59A8B69
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Impact of CT venography added to CT pulmonary angiography for the detection of deep venous thrombosis and relevant incidental CT findings.
Journal
European journal of radiology
Author(s)
Douek P., Rotzinger D.C., Meuli R.A., Dunet V., Schmidt S.
ISSN
1872-7727 (Electronic)
ISSN-L
0720-048X
Publication state
Published
Issued date
12/2020
Peer-reviewed
Oui
Volume
133
Pages
109388
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
To assess the additional diagnostic value of CT venography (CTV) simultaneously performed with CT pulmonary angiography (CTPA) in the context of thromboembolic disease for the detection of deep venous thrombosis (DVT) and other relevant incidental CT findings.
Retrospectively and consecutively, we included all patients referred to our emergency department within the last 24 months for suspected pulmonary embolism (PE) who underwent CTPA combined with CTV. Two radiologists blinded to clinical information and results independently analysed CTV images in the context of DVT of the lower extremities and other, unsuspected abdominal/pelvic findings. These latter were classified as relevant with therapeutic consequences or irrelevant. One radiologist reviewed patient clinical records. Inter-observer agreement for DVT detection was calculated.
Of 696 patients, 119 had PE (17.1%) and 54 had DVT (7.8%), 16 (2.3%) of them without concomitant PE. Inter-observer agreement between the two readers was substantial (kappa = 0.78). CTV examinations led to diagnosis of relevant incidental abdominal/pelvic findings in 40 (5.7%) patients, including 11 with new malignant tumours, and 8 with progressive metastatic disease. The evaluated clinical and biological risk factors were not significantly associated with the presence of relevant incidental findings. CTV changed therapeutic management in 29 patients (4.3%): 15 had DVTs without PE, and 14 had abdominal/pelvic findings with therapeutic consequences.
CTV simultaneously performed with CTPA offers limited incremental value for detecting DVT. It may reveal other relevant findings leading to therapeutic changes, but the low rate does not justify screening patients with suspected PE.
Keywords
CT angiography, Deep vein thrombosis, Incidental findings, Pulmonary embolism
Pubmed
Web of science
Open Access
Yes
Create date
23/11/2020 13:53
Last modification date
04/02/2021 6:25
Usage data