Incidence of pulmonary embolism and other chest findings in younger patients using multidetector computed tomography

Acta Radiol. 2010 May;51(4):402-6. doi: 10.3109/02841850903524439.

Abstract

Background: Multidetector computed tomography (MDCT) has become the first-line modality for imaging patients with suspected pulmonary embolism (PE). The disadvantages of MDCT, the use of ionizing radiation and iodinated contrast agents, are a reasonable cause of concern, especially in young patients, and therefore it is critical to understand the likelihood of PE in these patients to evaluate a risk benefit analysis.

Purpose: To calculate the incidence of PE and other chest findings on MDCT in a young adult population investigated for PE.

Material and methods: 387 consecutive patients (age 31.5+/-13.5 years) underwent chest MDCT for clinically suspected PE between January 2004 and August 2006. Incidence of PE and other chest findings were calculated with a confidence interval of 95% using binomial distribution.

Results: PE incidence was 5%; negative PE with other chest findings was 60%. In 89% of the patients with other chest findings, these included findings of the pleura and/or lung parenchyma. The main patterns of disease were lung opacification suggesting pneumonia (41%), atelectasis (12.4%), and nodular/mass findings (17.5%). In 34% of the patients, there was no PE and no other findings present.

Conclusion: There is a low incidence of PE in young patients imaged for PE with MDCT.

MeSH terms

  • Adolescent
  • Adult
  • Chi-Square Distribution
  • Contrast Media
  • Female
  • Humans
  • Incidence
  • Lung Diseases / diagnostic imaging
  • Lung Diseases / epidemiology
  • Male
  • Middle Aged
  • North Carolina / epidemiology
  • Pulmonary Embolism / diagnostic imaging*
  • Pulmonary Embolism / epidemiology*
  • Radiographic Image Interpretation, Computer-Assisted
  • Radiography, Thoracic
  • Tomography, X-Ray Computed / methods*

Substances

  • Contrast Media