Roles of spectral dual-layer CT, D-dimer concentration, and COVID-19 pneumonia in diagnosis of pulmonary embolism.
Eur J Radiol Open
; 12: 100575, 2024 Jun.
Article
en En
| MEDLINE
| ID: mdl-38882633
ABSTRACT
Purpose:
To demonstrate advantages of spectral dual-layer computed tomography (CT) in diagnosing pulmonary embolism (PE). To compare D-dimer values in patients with PE and concomitant COVID-19 pneumonia to those in patients without PE and COVID-19 pneumonia. To compare D-dimer values in cases of minor versus extensive PE.Methods:
A monocentric retrospective study of 1500 CT pulmonary angiographies (CTPAs). Three groups of 500 consecutive examinations 1) using conventional multidetector CT (CTC), 2) using spectral dual-layer CT (CTS), and 3) of COVID-19 pneumonia patients using spectral dual-layer CT (COV). Only patients with known D-dimer levels were enrolled in the study.Results:
Prevalence of inconclusive PE findings differed significantly between CTS and CTC (0.8â¯% vs. 5.4â¯%, p < 0.001). In all groups, D-dimer levels were significantly higher in PE positive patients than in patients without PE (CTC, 8.04 vs. 3.05â¯mg/L; CTS, 6.92 vs. 2.57â¯mg/L; COV, 10.26 vs. 2.72â¯mg/L, p < 0.001). There were also statistically significant differences in D-dimer values between minor and extensive PE in the groups negative for COVID-19 (CTC, 5.16 vs. 8.98â¯mg/L; CTS 3.52 vs. 9.27â¯mg/L, p < 0.001). The lowest recorded D-dimer value for proven PE in patients with COVID-19 pneumonia was 1.19â¯mg/L.Conclusion:
CTPAs using spectral dual-layer CT reduce the number of inconclusive PE findings. Plasma D-dimer concentration increases with extent of PE. Cut-off value of D-dimer with 100â¯% sensitivity for patients with COVID-19 pneumonia could be doubled to 1.0â¯mg/L. This threshold would have saved 110 (22â¯%) examinations in our cohort.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
Eur J Radiol Open
Año:
2024
Tipo del documento:
Article