Keywords:
Performed at one institution, Cross-sectional study, Retrospective, Quality assurance, Acute, Diagnostic procedure, CT-Angiography, Thorax, Pulmonary vessels, Emergency Imaging
Authors:
M. M. Abdullah, U. S. Umer, A. Nawaz Khan, S. Alam, H. Abid, S. Ghulam ghaus, S. Rughafi, S. Nawaz; Peshawar/PK
DOI:
10.26044/ecr2020/C-13152
Purpose
Pulmonary embolism (PE) is the third most common acute cardiovascular disease next to myocardial infarction and stroke 1. A large academic study 2 showed that the number of CTPA performed for suspected had increased considerably, with meanwhile decrease in number of Perfusion scan and pulmonary angiography. Nowadays the CTPA is considered as the investigation of choice for suspected PE 3. The diagnostic accuracy of CTPA for PE up to segmental level is very high, with sensitivity ranging from 90–100 and specificity of 89–94% keeping pulmonary angiography as gold standard 4,5
In a large study the study was indeterminate in 6.6% 6 and 10.8%8 of cases, and the most common cause was motion artefact (74%), followed by poor enhancement (40%), parenchymal disease (12%), streak artefacts and body habitus (7%) 6. Adequate opacificaiton of the main pulmonary artery is essential for the detection of thrombus. The density of the pulmonary thrombus depends in the chronicity. The density of acute and chronic thrombus is 33 and 87HU respectively. The minimum attenuation of the blood to detect all the acute and chronic thrombi should be 93HU and 210HU respectively7.
The aim of the audit is to evaluate the adequacy of the angiograms done for diagnosis of pulmonary embolism.