Correlation between the site of pulmonary embolism and the extent of deep vein thrombosis: evaluation by computed tomography pulmonary angiography and computed tomography venography

Jpn J Radiol. 2011 Apr;29(3):171-6. doi: 10.1007/s11604-010-0533-y. Epub 2011 Apr 26.

Abstract

Purpose: The aim of this study was to evaluate the relation between the sites of pulmonary embolism (PE) and deep vein thrombosis (DVT) by computed tomography pulmonary angiography (CTPA) and CT venography (CTV) of the pelvis and lower extremities.

Materials and methods: We retrospectively reevaluated CTPA-CTV data sets for 227 consecutive patients suspected of having a PE. The PEs were divided into proximal (located at the lobar artery or proximal to it) and distal groups. DVTs were divided into proximal (located above the knee) and distal groups. Cohen's kappa statistic and chi-squared tests were performed.

Results: The incidence of PE was significantly higher in patients with a proximal DVT than with a distal DVT (P < 0.01). In patients with a proximal DVT, the incidence of proximal PE was significantly higher than that of distal PE (P < 0.05). In patients with a proximal DVT, the incidence of PE was significantly higher in patients with a right-side DVT than with a left-side DVT (P < 0.05).

Conclusion: Proximal PEs were correlated with proximal DVTs. Patients with a proximal DVT tended to have a PE, especially with a right-proximal DVT. Hence, the presence of a right-proximal DVT has the potential for serious complications, and carefully diagnosis is required for PE and DVT.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography / methods
  • Contrast Media
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted
  • Iopamidol
  • Lower Extremity / blood supply
  • Lower Extremity / diagnostic imaging
  • Male
  • Middle Aged
  • Observer Variation
  • Pelvis / blood supply
  • Pelvis / diagnostic imaging
  • Phlebography
  • Pulmonary Embolism / complications
  • Pulmonary Embolism / diagnostic imaging*
  • Radiographic Image Enhancement
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*
  • Venous Thrombosis / complications
  • Venous Thrombosis / diagnostic imaging*

Substances

  • Contrast Media
  • Iopamidol