Stein Paul, Matta Fadi, Gerstner Brett J, Kakish Edward J, Hughes Patrick G, Lata Julie, Trigger Christopher C, Jutzy Kevin A, Doyle Michael Q, Warpinski Mathew A, Corser William D, Long Jerome P, Fakhouri Nasheed S, Jones Corion L, Owen Kristen N, Lyons Casey, Carracedo Damien, Skinner Ian P, Warner Laura A, Saffer Ethan R, Deming Brody A, Cronovich Keith D, Hughes Mary J
Michigan State University.
Sparrow Health.
Spartan Med Res J. 2020 Jan 30;4(2):11769. doi: 10.51894/001c.11769.
One advantage of computed tomographic pulmonary angiograms (CTPA) is that they often show pathology in patients in whom pulmonary embolism (PE) has been excluded. In this investigation, we identified the ancillary findings on CTPAs that were negative for PE to obtain an impression of the type of findings shown.
This was a retrospective analysis of findings on CTPAs that were negative for PE obtained in nine emergency departments between January 2016 - February 2018. Ancillary findings were assessed by review of the radiographic reports.
Ancillary findings were identified in N=338 (40.9%) of 825 patients with CTPAs that were negative for PE. Most ancillary findings, 254 (75.1%) of 338 were pulmonary or pleural abnormalities. Liver, gall bladder, kidney, or pancreatic abnormalities were shown in 26 (7.7%) cases, and abnormalities of the heart or great vessels were shown in 23 (6.8%) of cases. Abnormalities of the esophagus or intestine were shown in 12 (3.6%), abnormalities of the thyroid in 10 (3.0%) and abnormalities of bone or soft tissue lesions were shown in three (0.9%) cases. Inferential statistical procedures demonstrated that the occurrence of ancillary findings in patients with negative CTPAs was proportionately greater in patients who were 50 years and older (p < 0.001), although not between genders (p = 0.145).
Ancillary findings on CTPAs that were negative for PE were frequently reported. Future studies might focus of the extent to which ancillary findings on CTPA assisted physicians in management of the patient.
计算机断层扫描肺动脉造影（CTPA）的一个优点是，它们常常能在已排除肺栓塞（PE）的患者中显示出病变情况。在本研究中，我们确定了CTPA上PE为阴性的辅助性发现，以了解所显示的发现类型。
这是一项对2016年1月至2018年2月期间在9个急诊科获得的PE为阴性的CTPA检查结果的回顾性分析。通过审查影像学报告评估辅助性发现。
在825例PE为阴性的CTPA患者中，有338例（40.9%）发现了辅助性发现。大多数辅助性发现，即338例中的254例（75.1%）为肺部或胸膜异常。26例（7.7%）显示肝脏、胆囊、肾脏或胰腺异常，23例（6.8%）显示心脏或大血管异常。12例（3.6%）显示食管或肠道异常，10例（3.0%）显示甲状腺异常，3例（0.9%）显示骨骼或软组织病变异常。推断性统计程序表明，CTPA为阴性的患者中辅助性发现的发生率在50岁及以上的患者中相对更高（p<0.001），但在不同性别之间无差异（p = 0.145）。
经常报告CTPA上PE为阴性的辅助性发现。未来的研究可能聚焦于CTPA上的辅助性发现对医生管理患者的帮助程度。
