Recently, a diagnostic strategy using a clinical decision rule, D-dimer testing and spiral computed tomography (CT) was found to be effective in the evaluation of patients with clinically suspected pulmonary embolism (PE). However, the rate of venous thromboembolic complications in the three-month follow-up of patients with negative CT was still substantial and included fatal events. It was the objective to evaluate the safety of withholding anticoagulants after a normal 64-detector row CT (64-DCT) scan from a cohort of patients with suspected PE. A total of 545 consecutive patients with clinically suspected first episode of PE and either likely pre-test probability of PE (using the simplified Wells score) or unlikely pre-test probability in combination with a positive D-dimer underwent a 64-DCT. 64-DCT scanning was inconclusive in nine patients (1.6%), confirmed the presence of PE in 169 (31%), and ruled out the diagnosis in the remaining 367. During the three-month follow-up of the 367 patients one developed symptomatic distal deep-vein thrombosis (0.27%; 95%CI, 0.0 to 1.51%) and none developed PE (0 %; 95%CI, 0 to 1.0%). We conclude that 64-DCT scanning has the potential to safely exclude the presence of PE virtually in all patients presenting with clinical suspicion of this clinical disorder.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1160/TH10-10-0638 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Rare Coronary Artery Anomaly: Single Coronary Artery from Distal Circumflex Detected by CT.
Am J Case Rep
January 2025
Department of Cardiology, Centre Hospitalier François Mitterrand de Pau (CHPAU), Pau, France.
BACKGROUND A single coronary artery is a rare congenital anomaly of the coronary arteries distribution, with an incidence of only 0.03% in the general population undergoing coronary angiography. RCA arising from the distal circumflex artery is an extremely rare variety.
View Article and Find Full Text PDFEffectiveness of the air-gap method for reducing radiation dose in neonate CT examinations.
Radiol Phys Technol
November 2024
Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Article Synopsis
- The air-gap method is a technique used in medical imaging that creates a space of air between the radiation source and the patient to minimize radiation scattering and improve dose distribution.
- This study focused on evaluating the effectiveness of the air-gap method in reducing radiation exposure for pediatric patients undergoing computed tomography (CT) scans, using a specific neonate phantom and a 64 detector-row CT scanner.
- Results showed that the air-gap method reduced exposure dose and image noise by approximately 10% and 15%, respectively, compared to conventional methods, indicating its potential benefits in pediatric imaging (p < 0.05).
Usefulness of the superior orbitomeatal line without the lens included in the scan range at different tube voltage during pediatric head CT.
Radiologia (Engl Ed)
October 2024
Departamento de Radiología Diagnóstica, Escuela de Grado de Ciencias Biomédicas, Universidad de Hiroshima, Hiroshima, Hiroshima, Japan.
Introduction And Objectives: To compare the real time skin dosimeter values at lens between with the lens included in the scan range (orbitomeatal base line [OML]) or without the lens included in the scan range (superior orbitomeatal line [SOML]) at different tube voltages.
Materials And Methods: We used three pediatric anthropomorphic phantoms with a 64 detector-row computed tomography (CT) scanner with the OML- or SOML-protocol at different tube voltages during the head CT. A real time skin dosimeter was inserted into the phantom center of the head, and surfaces of the lens.
[Accuracy Verification for Slice Sensitivity Profile Measurement Method by Averaging the Multiple Tilted Wires in Computed Tomography Image].
Nihon Hoshasen Gijutsu Gakkai Zasshi
April 2024
B.B.M.I.L.
Purpose: Several studies present the unsuitability of the tilted-wire method for slice sensitivity profile (SSP) in helical scan. We compared the accuracy for SSP by the tilted-wire averaging method using multiple wire profiles and by the conventional micro-coin method.
Methods: A micro-coin phantom positioned at the center or the off-center was scanned using a 64-detector row CT scanner in different positions where an X-ray tube starts scanning.
Optimizing Coronary Computed Tomography Angiography Using a Novel Deep Learning-Based Algorithm.
J Imaging Inform Med
August 2024
Department of Radiology, Neuroradiology and Nuclear Medicine, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany.
Coronary computed tomography angiography (CCTA) is an essential part of the diagnosis of chronic coronary syndrome (CCS) in patients with low-to-intermediate pre-test probability. The minimum technical requirement is 64-row multidetector CT (64-MDCT), which is still frequently used, although it is prone to motion artifacts because of its limited temporal resolution and z-coverage. In this study, we evaluate the potential of a deep-learning-based motion correction algorithm (MCA) to eliminate these motion artifacts.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!