caa a22 4500 475842146 CHVBK 20180406123903.0 cr unu---uuuuu 170329e20000301xx s 000 0 eng 10.1007/s101400050006 doi (NATIONALLICENCE)springer-10.1007/s101400050006 The role of spiral CT using the pulmonary embolus protocol: a comparison of emergency department and hospitalized populations [Elektronische Daten] [A. B. Montgomery, R. C. Gilkeson, J. Glauser, K. E. Applegate] Purpose: To compare the incidence of CT scan-detected pulmonary embolism, the CT scan-detected alternative findings (ancillary findings and alternative radiologic diagnoses), and the patient characteristics in emergency department and in hospitalized patients. Materials and methods: 81 spiral CT scans in 79 consecutive adult emergency department patients were retrospectively identified by computer search. During the same 9-month interval, 131 consecutive adult in-patients were similarly identified. The in-house and emergency department populations were compared in respect of incidence of pulmonary embolism and alternative findings using χ 2 analysis. Results: 81 emergency department scans and 135 in-patient scans were evaluated. Of these, 22 emergency department scans (27.1 %) and 37 in-patient scans (27.4 %) were positive for pulmonary embolism. Of the scans that were negative for a pulmonary embolism, 45 emergency department scans (76.2 %) and 88 in-patient scans (89.8 %) were positive for alternative findings. These included atelectasis, adenopathy, metastatic disease, and pneumomediastinum. Alternative radiologic diagnoses on scans negative for pulmonary embolism occurred in 8/59 emergency department patients (13.5 %) and in 17/98 in-patients (17.3 %). These included pneumonia, tumor, mucus plugging, pericardial effusions, and thoracic aortic dissection. Conclusions: No significant difference exists between the emergency department and in-patient populations for the incidence of pulmonary embolism on spiral CT scans. Although a significant difference did exist between these populations in respect to alternative findings, the high percentage of alternative findings in both populations shows a possible advantage of CT over the traditional test, the ventilation-perfusion scan. Therefore, spiral CT should not be limited to the in-patient population as the first-line imaging modality for the diagnostic evaluation of pulmonary embolism. American Society of Emergency Radiology, 2000 Key words Pulmonary embolism - Spiral CT - Ventilation-perfusion scan nationallicence Montgomery A. B. Department of Diagnostic Radiology, University Hospitals of Cleveland, 11100 Euclid Ave., Cleveland, OH 44106, USA e-mail: Monty1989@hotmail.com Tel.: + 1-2 16-8 44 31 13 Fax: + 1-2 16-8 44 39 05, US aut Gilkeson R. C. Department of Diagnostic Radiology, University Hospitals of Cleveland, 11100 Euclid Ave., Cleveland, OH 44106, USA e-mail: Monty1989@hotmail.com Tel.: + 1-2 16-8 44 31 13 Fax: + 1-2 16-8 44 39 05, US aut Glauser J. Department of Emergency Medicine, University Hospitals of Cleveland, Cleveland, Ohio, USA, US aut Applegate K. E. Department of Diagnostic Radiology, University Hospitals of Cleveland, 11100 Euclid Ave., Cleveland, OH 44106, USA e-mail: Monty1989@hotmail.com Tel.: + 1-2 16-8 44 31 13 Fax: + 1-2 16-8 44 39 05, US aut https://doi.org/10.1007/s101400050006 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s101400050006 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Montgomery A. B. Department of Diagnostic Radiology, University Hospitals of Cleveland, 11100 Euclid Ave., Cleveland, OH 44106, USA e-mail: Monty1989@hotmail.com Tel.: + 1-2 16-8 44 31 13 Fax: + 1-2 16-8 44 39 05, US aut NATIONALLICENCE 700 1- Gilkeson R. C. Department of Diagnostic Radiology, University Hospitals of Cleveland, 11100 Euclid Ave., Cleveland, OH 44106, USA e-mail: Monty1989@hotmail.com Tel.: + 1-2 16-8 44 31 13 Fax: + 1-2 16-8 44 39 05, US aut NATIONALLICENCE 700 1- Glauser J. Department of Emergency Medicine, University Hospitals of Cleveland, Cleveland, Ohio, USA, US aut NATIONALLICENCE 700 1- Applegate K. E. Department of Diagnostic Radiology, University Hospitals of Cleveland, 11100 Euclid Ave., Cleveland, OH 44106, USA e-mail: Monty1989@hotmail.com Tel.: + 1-2 16-8 44 31 13 Fax: + 1-2 16-8 44 39 05, US aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer