Spiral computed tomographic pulmonary angiography for investigating suspected pulmonary embolism: clinical outcomes

Purpose: To assess the clinical outcomes of patients who were suspected of having acute pulmonary embolism and underwent spiral computed tomographic pulmonary angiography (CTPA) for diagnosis. Methods: We evaluated the clinical outcomes of 62 patients with suspected pulmonary embolism; 82 CTPA scans were performed in a 15-month period. Clinical outcomes were recorded for all patients for a minimum of 3 months. Results: Acute pulmonary embolism was diagnosed and treated in 11 (18%) of the 62 patients evaluated via CTPA. Scans of the other 51 (82%) patients were negative for pulmonary embolism. Seven (14%) of these patients died during the 3-month follow-up period; pulmonary embolism was considered to be a contributing factor in 1 of these deaths. Seven (14%) of the 51 patients were lost to follow-up, and 37 (74%) showed no evidence of disease at least 3 months after a negative CTPA study. Despite the presence or absence of an acute pulmonary embolism, an alternate or additional diagnosis was made on 32 (52%) CTPA scans. Conclusion: Spiral CTPA can be effectively used to rule out clinically significant pulmonary emboli and also serves to provide alternate diagnoses in patients who do not have a pulmonary embolism.