Introduction: Thoracic CT angiography is the gold standard for investigating thoracic vascular emergencies, particularly in cases of suspected pulmonary embolism. This study aims to evaluate its use, technical performance, and diagnostic results at the Point G University Hospital. Methods: This is a descriptive study of thoracic CT angiograms performed during the study period. The parameters analyzed included epidemiological data, indications, technical modalities, and diagnostic results. Results: Of 2777 imaging examinations, 780 CT scans were performed, including 63 thoracic CT angiograms (8.1%). The mean age of the patients was 58 ± 12 years, with a female predominance (56%). The majority of patients were hospitalized (76%). The main indication was suspected pulmonary embolism (48%). Examinations were performed according to standardized protocols with a technical success rate of 96.8%. Pulmonary embolism was found in 38% of cases, followed by aortic dissection (30%). Conclusion: Thoracic CT angiography appears to be a reliable and effective modality in our setting. Despite limited resources, the technical quality and diagnostic yield are satisfactory. Improved accessibility and further studies could optimize the management of thoracic vascular emergencies.
References
[1]
Schoepf, U.J., Goldhaber, S.Z. and Costello, P. (2004) Spiral Computed Tomography for Acute Pulmonary Embolism. Circulation, 109, 2160-2167. https://doi.org/10.1161/01.cir.0000128813.04325.08
[2]
Remy-Jardin, M. and Remy, J. (1999) Spiral CT Angiography of the Pulmonary Circulation. Radiology, 212, 615-636. https://doi.org/10.1148/radiology.212.3.r99se02615
[3]
Moores, L.K., Tritschler, T., Brosnahan, S., Carrier, M., Collen, J.F., Doerschug, K., et al. (2020) Prevention, Diagnosis, and Treatment of VTE in Patients with Coronavirus Disease 2019: CHEST Guideline and Expert Panel Report. Chest, 158, 1143-1163. https://doi.org/10.1016/j.chest.2020.05.559
[4]
Konstantinides, S.V., Meyer, G., Becattini, C., Bueno, H., Geersing, G., Harjola, V., et al. (2019) 2019 ESC Guidelines for the Diagnosis and Management of Acute Pulmonary Embolism Developed in Collaboration with the European Respiratory Society (ERS). European Heart Journal, 41, 543-603. https://doi.org/10.1093/eurheartj/ehz405
[5]
Bae, K.T. (2010) Intravenous Contrast Medium Administration and Scan Timing at CT: Considerations and Approaches. Radiology, 256, 32-61. https://doi.org/10.1148/radiol.10090908
[6]
Kligerman, S.J., Mitchell, J.W., Sechrist, J.W., Meeks, A.K., Galvin, J.R. and White, C.S. (2018) Radiologist Performance in the Detection of Pulmonary Embolism. Journal of Thoracic Imaging, 33, 350-357. https://doi.org/10.1097/rti.0000000000000361
[7]
Kaykisiz, E.K., Unluer, E.E. and Eser, U. (2018) The Diagnosis of Pulmonary Embolism without Contrastis Not Always Challenging: Be Aware of Hyperdense Lumen Sign. Pan African Medical Journal, 30, Article No. 279. https://doi.org/10.11604/pamj.2018.30.279.16283
Isselbacher, E.M., Preventza, O., Hamilton Black, J., Augoustides, J.G., Beck, A.W., Bolen, M.A., et al. (2022) 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation, 146, e334-e482. https://doi.org/10.1161/cir.0000000000001106
[10]
Erbel, R., Aboyans, V., Boileau, C., Bossone, E., Bartolomeo, R.D., Eggebrecht, H., et al. (2014) 2014 ESC Guidelines on the Diagnosis and Treatment of Aortic Diseases. European Heart Journal, 35, 2873-2926. https://doi.org/10.1093/eurheartj/ehu281