Abstract 1599: Anatomic Distribution of Pulmonary Emboli (PE) at Pulmonary Angiography in a Consecutive Series of Patients with Suspected Pulmonary Embolism
AUTHORS:
J.W. Wallis, MD, E.J. Van Beek, MD, PhD, G.J. Den Heeten, MD, PhD.
ABSTRACT:
PURPOSE: The distribution of pulmonary emboli and incidence of isolated subsegmental PE in a consecutive series of patients with suspected pulmonary embolism, was studied.
METHOD AND MATERIALS: All consecutive in- and outpatients with clinically suspected pulmonary embolism were included over a two-year period. Bilateral, selective pulmonary angiography was performed. The number of embolic segments and the order of the emboli were scored by two independent, blinded reviewers.
RESULTS: Angiography was performed in 143 of 150 eligible patients and showed PE in 35 (prevalence 25%). Emboli were bilateral, right or left in 16 (46%), 13 (37%) and 6 (17%), respectively. The lower lobes contained 65 of 122 embolic segments (53%). Patients had an average of 3.6 embolic segments. Most emboli (87 of 122; 79%) were detetected in the larger arteries (second to fourth order vessels), while 35 (29%) subsegmental segments showed emboli. Isolated subsegmental emboli were diagnosed in 5 patients (15%; 95% CI: 5-30%).
CONCLUSIONS: 15% of the patients with proven emboli, had isolated subsegmental emboli. This has potential implications for the clinical application of spiral computed tomography.
