Abstract
Background: CTPA is 1st line imaging of suspected pulmonary emboli (PE) in UK hospitals.
Aims and objectives: CTPA yields 3-D images of thoracic and upper abdominal organs, thus detects unanticipated diagnoses termed “incidental findings” (IF). We investigated the nature of IFs on CTPAs done at Dorset County Hospital.
Methodology: All CTPA reports from October-09 to March-10 were retrospectively reviewed, noting diagnosis of PE (positive CTPA), additional findings, particularly IFs, validated against previous imaging reports.
Results: Total CTPA reports were 490 (51% males). PE was diagnosed on 113 (23.0% ± 3.73%, 95% CI). Total additional findings were 781. Mean additional findings per CTPA was 1.6±0.11 (95% CI). Total IFs were 515, 335 of pulmonary origin (65.05% ±4.66%, 95% CI), including pleural effusions (81), consolidation (66), emphysema (36), lung collapse (35), pulmonary nodules (26), pulmonary fibrosis (23), lymphadenopathy (13), pulmonary oedema (13), bronchiectasis (10) and malignancy (9). Other IFs included aortic dissection (1), abdominal aortic aneurysm (5), aortic thrombus (1), pericardial effusion (22), cardiomegaly (15), lobulated heart lesion (1), obstructed biliary (1) and renal tracts (1), pancreatitis (1), incarcerated hiatus hernia (1), free intra-abdominal gas (1) and ruptured breast prosthesis (1).
Discussion: Proportion of CTPAs positive for PE, 23%, was comparable to other studies. This study further emphasises importance of CTPA in not only diagnosing PE, but also detecting alternate pathologies, thus enabling optimal patient management, though additional costs would have arisen in pursuing the IFs.
- © 2011 ERS
