ANATOMIC DISTRIBUTION OF PULMONARY EMBOLI AT PULMONARY ANGIOGRAPHY - IMPLICATIONS FOR CROSS-SECTIONAL IMAGING

PURPOSE: To determine how often emboli detected angiographically in pe ripheral pulmonary arterial branches would be missed with cross-sectio nal imaging. MATERIALS AND METHODS: Seventy-nine of 88 consecutive pul monary angiograms interpreted as positive for pulmonary emboli were re viewed retrospectively to detect pulmonary emboli. Three angiograms in terpreted as negative when reviewed retrospectively were excluded. Fin dings of 76 angiograms in 76 patients (32 men, 44 women; aged 19-85 ye ars) were correlated with the results of scintigraphy (n = 72) and Dop pler ultrasound (n = 60), clinical presentation (n = 76), and follow-u p with chart review (n = 72). RESULTS: Two hundred five emboli were id entified. Nineteen patients had solitary emboli. Sixty emboli were in the upper lobes. The largest arterial branch with pulmonary embolism w as lobar in 14 patients, segmental in 38, subsegmental in 20, and smal ler in three. CONCLUSION: If cross-sectional imaging can depict emboli in only segmental and larger arterial branches, then emboli in 23 of 76 patients (30%) would have been missed with cross-sectional imaging.