Small pulmonary artery defects are not reliable indicators of pulmonary embolism

Annals of the American Thoracic Society

Volumn 12, Issue 7, 2015, Pages 1022-1029

  Miller, Wallace T ^a   Marinari, Lawrence A ^b   Barbosa, Eduardo ^a   Litt, Harold I ^a   Schmitt, James E ^a   Mahne, Anton ^c   Lee, Victor ^b   Akers, Scott R ^d  

^a UNIVERSITY OF PENNSYLVANIA   (United States)

^b BRYN MAWR HOSPITAL   (United States)

^c Department of Surgery   (United States)

^d VETERANS AFFAIRS MEDICAL CENTER   (United States)

Author keywords

Community hospitals; Diagnostic errors; False positive reactions; Pulmonary embolism; X ray computed tomography

Indexed keywords

IODIXANOL; IOVERSOL;

ARTICLE; COMMUNITY HOSPITAL; COMPUTED TOMOGRAPHIC ANGIOGRAPHY; COMPUTED TOMOGRAPHY SCANNER; DIAGNOSTIC ACCURACY; DIGITAL IMAGING AND COMMUNICATIONS IN MEDICINE; FALSE POSITIVE RESULT; HEALTH CARE; HUMAN; LUNG EMBOLISM; MULTIDETECTOR COMPUTED TOMOGRAPHY; PREDICTIVE VALUE; PULMONARY VASCULAR DISEASE; RADIOLOGIST; UNITED STATES; ANGIOGRAPHY; CLINICAL TRIAL; COMPUTER ASSISTED TOMOGRAPHY; LABORATORY DIAGNOSIS; MULTICENTER STUDY; PATHOLOGY; PULMONARY ARTERY; RADIOGRAPHY;

ANGIOGRAPHY; FALSE POSITIVE REACTIONS; HOSPITALS, COMMUNITY; HUMANS; PULMONARY ARTERY; PULMONARY EMBOLISM; TOMOGRAPHY, X-RAY COMPUTED; UNITED STATES;

EID: 84942238698     PISSN: 23296933     EISSN: 23256621     Source Type: Journal    
DOI: 10.1513/AnnalsATS.201502-105OC     Document Type: Article

References (16)

1. British Thoracic Society Standards of Care Committee Pulmonary Embolism Guideline Development Group. British Thoracic Society guidelines for the management of suspected acute pulmonary embolism. Thorax 2003;58:470-483.
2. Perrier A, Roy PM, Sanchez O, Le Gal G, Meyer G, Gourdier AL, Furber A, Revel MP, Howarth N, Davido A, et al. Multidetector-row computed tomography in suspected pulmonary embolism. N Engl J Med 2005;352:1760-1768.
3. Stein PD, Fowler SE, Goodman LR, Gottschalk A, Hales CA, Hull RD, Leeper KV Jr, Popovich J Jr, Quinn DA, Sos TA, et al.; PIOPED II Investigators. Multidetector computed tomography for acute pulmonary embolism. N Engl J Med 2006;354:2317-2327.
4. R Development Core Team. R: a language and environment for statistical computing. Vienna, Austria; 2014.
5. Randolph JJ. Free-marginal multirater kappa: an alternative to Fleiss? fixed marginal multirater kappa. Joensuu University Learning and Instruction Symposium, 2005.
6. Dahiya A, Bolen M, Grimm RA, Rodriguez LL, Thomas JD, Marwick TH; AR Concordance Investigators. Development of a consensus document to improve multireader concordance and accuracy of aortic regurgitation severity grading by echocardiography versus cardiac magnetic resonance imaging. Am J Cardiol 2012;110: 709-714.
7. Beigelman C, Chartrand-Lefebvre C, Howarth N, Grenier P. Pitfalls in diagnosis of pulmonary embolism with helical CT angiography. AJR Am J Roentgenol 1998;171:579-585.
8. Remy-Jardin M, Remy J, Artaud D, Deschildre F, Fribourg M, Beregi JP. Spiral CT of pulmonary embolism: technical considerations and interpretive pitfalls. J Thorac Imaging 1997;12:103-117.
9. Wiener RS, Schwartz LM, Woloshin S. Time trends in pulmonary embolism in the United States: evidence of overdiagnosis. Arch Intern Med 2011;171:831-837.
10. Ryu JH, Olson EJ, Pellikka PA. Clinical recognition of pulmonary embolism: problem of unrecognized and asymptomatic cases. Mayo Clin Proc 1998;73:873-879.
11. Musset D, Parent F, Meyer G, Maître S, Girard P, Leroyer C, Revel MP, Carette MF, Laurent M, Charbonnier B, et al.; Evaluation du Scanner Spiralédans l?Embolie Pulmonaire study group. Diagnostic strategy for patients with suspected pulmonary embolism: a prospective multicentre outcome study. Lancet 2002;360:1914-1920.
12. Ghaye B, Szapiro D, Mastora I, Delannoy V, Duhamel A, Remy J, Remy-Jardin M. Peripheral pulmonary arteries: how far in the lung does multi-detector row spiral CT allow analysis? Radiology 2001;219: 629-636.
13. Schoepf UJ, Goldhaber SZ, Costello P. Spiral computed tomography for acute pulmonary embolism. Circulation 2004;109:2160-2167.
14. Carrier M, Righini M, Wells PS, Perrier A, Anderson DR, Rodger MA, Pleasance S, Le Gal G. Subsegmental pulmonary embolism diagnosed by computed tomography: incidence and clinical implications. A systematic review and meta-analysis of the management outcome studies. J Thromb Haemost 2010;8:1716-1722.
15. Coche E, Verschuren F, Keyeux A, Goffette P, Goncette L, Hainaut P, Hammer F, Lavenne E, Zech F, Meert P, et al. Diagnosis of acute pulmonary embolism in outpatients: comparison of thin-collimation multi-detector row spiral CT and planar ventilation-perfusion scintigraphy. Radiology 2003;229:757-765.
16. Eyer B, Goodman L, Washington L. Clinicians? response to radiologists? reports of isolated subsegmental pulmonary embolism or inconclusive interpretation of pulmonary embolism using MDCT. AJR 2005;184:623-628.