Abstract

The Role of Computed Tomography in the Diagnosis of Acute and Chronic Pulmonary Embolism (CTPA) in Multi Centers at Riyadh Region

Pulmonary Embolism (PE), of acute type, is considered a significant reason for mortality due to cardiovascular cause. PE incidence is estimated to be about 60 to 70/100,000. However, the exact incidence could be higher due to silent PE. The PE incidence is rising in contrast to Deep Vein Thrombosis (DVT) that is declining. Diagnosis of PE may be a difficult task since clinical presentations (signs and symptoms) are variable especially in presence of comorbidities and laboratory tests are not that specific. Imaging techniques are of significant importance as suspected PE diagnostic evaluation. Computed Tomography Pulmonary Angiography (CTPA) is a frequently used imaging technique in cases of clinical high probability PE and positive D-dimer test. This study aimed at studying the correlation between blood investigations and Computed Tomography (CT) for diagnosis of Pulmonary Embolism (PE), also to determine the characteristics and accuracy of CT in detecting PE and to evaluate the incidence of PE according to males and females and to determine the most common comorbidities before the PE event. In this study, about half of the studied cases (47.1%) have chronic PE, one-third of the sample have acute PE (33.1%), while, (19.8%) of the sample study have massive PE. The Wells scoring was applied for the evaluation of risk probability because of its accuracy in the prediction of PE in suspected cases. There is a statically strong positive relation between blood investigation and CT of PE in the studied cases. It is recommended that patients with a high-risk probability of PE are recommended to perform CTPA directly without D-dimer testing.

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