Incidental Findings in Patients Evaluated for Pulmonary Embolism Using Computed Tomography Angiography

Document Type: Original Article

Authors

1 Radiologist, Vascular and Endovascular Surgery Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Radiologist, Radiology Department, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

3 Emergency Medicine Specialist, Emergency Medicine Department, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

4 Resident of Radiology, Radiology Department, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Introduction: Pulmonary embolism (PE) is a common lethal disease that its clinical symptoms may be seen in many other diseases. Computed tomography pulmonary angiography (CTPA) is a valuable diagnostic modality for detection of PE. In addition, it can accurately detect the other diseases with clinical symptoms similar to PE. The aim of this study is to evaluate the frequency of PE and nonembolic disease with similar clinical symptoms including pulmonary, pleural, mediastinal, and cardiovascular diseases that have been detected by CTPA and to describe the importance of reporting these CT findings.
Materials and Methods: In this cross‐sectional study, we evaluated the medical records of CTPA in 300 patients of suspected PE between March 2012 and February 2013 in Imam Reza Hospital and Ghaem Hospital in Mashhad University of Medical Sciences, Mashhad, Iran. Demographic information and the results of CTPA of these patients were re‐evaluated. One radiologist reviewed all of the CTPA and the results have been analyzed by SPSS‐16 software.
Results: In this study, PE was detected in 18.7% of patients. Multiple incidental imaging findings were diagnosed as follow: pulmonary consolidation (33.2%), pleural effusion (48.7%), pulmonary nodules (10%), pulmonary masses (1.3%), pneumothorax (4.7%), mediastinal mass and lymphadenopathy (9.3%), aortic calcification (42%), coronary arteries calcification (27.3%), mitral valve calcification (2 %), cardiomegaly (30.7%), and the evidences of right ventricular dysfunction (6.7%).
Conclusion: A group of disease can cause the clinical symptoms similar to that of PE. Among them, pulmonary consolidation and pleural effusion have much higher frequency than PE. In addition, CTPA can show pathologic findings in the patients that need follow‐up. It is important to detect and report these imaging findings because some of them may change the treatment and prognosis of patient who are suspected to have PE.

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