Evaluation of Clinical, Instrumental and Laboratory Findings in Patients With Acute Pulmonary Embolism Diagnosed by Spiral CT Angiography

Objective:

To investigate the correlations between spiral CT angi­ography and symptoms, signs, laboratory and instrumental findings in patients with suspected pulmonary embolism (PE).

Methods:

Thirty-seven consecutive patients with suspicion of PE were included in the study. Electrocardiography, chest radiography, arterial blood gases analysis and D-dimer assay were performed in all patients. Five patients were excluded from the study due to low cli­nical probability and normal D-dimer levels. Spiral CT angiography and transthoracic echocardiography were applied to 32 patients with low clinical probability for PE and increasing D-dimer level (n=7), intermediate clinical probability for PE (n=5) and high pro­bability (n=20). The patients were classified as group 1, those with PE (n=21) and group 2, those without PE (n=ll).

Results:

The two groups were similar in age and sex. Substernal pain (61.9%), dyspnea (100%) and syncope (28.6%) were signi­ficantly more frequent in group 1. Frequency of tachycardia (81%), tachypnea (95.2%), hemoptysis (47.6%) and circulatory collapse (28.6%) were also significantly higher in group 1. S1Q3T3 and sinus tachycardia were significant ECG findings and pleural effusion (81%), atelectasis (71.4%), pleural based opacity (71.4%) and prominent central pulmonary artery were also significant findings, in group 1. Mean values for pH, PaO2, PaCO2, O2sat % and alveolar-oxygen gradient in groups 1 and 2, in respective order, were: 7.44±0.04 versus 7.4O±O.OO7; 49.54+9.07 versus 63.34±16.05; 31.63±8.21 versus 37.32+9.74; 81.08±5.36 versus 88.58±8.61 and 60.92+14.96 versus 40.01 + 14.36. All echocardiographic abnormalities were of signi­ficantly higher frequency in group 1.

Conclusion:

Spiral CT angiography can be used as a first line and safe diagnostic method in patients with suspected PE.