How accurate is multidetector CT angiography (MDCTA) for screening patients with suspected pulmonary embolism?

Bottom line:  Close to 20% of patients with negative chest CT will have a pulmonary embolism.

Summary:  Stein PD, et al.  Multidetector Computed Tomography for Acute Pulmonary Embolism [PIOPED II].  New Engl J Med.  2006; 354: 2317-2327.

Prospective study of 1,090 adults with suspected pulmonary embolism.  All patients received Wells scoring; MDCTA of chest alone and combined with venous-phase imaging of pelvic and thigh veins (CT angiography-CT venography [CTA-CTV]) using 4-row, 8-row, or 16-row multidetector scanners; ventilation-perfusion scanning; venous compression ultrasound of lower extremities; pulmonary digital-subtraction angiography if noninvasive tests were inconclusive.

Reference standard was composite of Wells score, MDCTA of chest, VQ scan, ultrasound, and pulmonary digital-subtraction angiography with 6 month follow up.

RESULTS:  CTA had 83% sensitivity and 96% specificity.

Study identified in DynaMed Pulmonary Embolism summary.


About Amy

Clinical Informationist at EUH Branch Library
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