PULMONARY-EMBOLISM - DIAGNOSIS WITH CONTRAST-ENHANCED ELECTRON-BEAM CT AND COMPARISON WITH PULMONARY ANGIOGRAPHY

PURPOSE: To determine the sensitivity and specificity of contrast mate rial-enhanced electron-beam computed tomography (CT) in the diagnosis; of pulmonary embolism (FE). MATERIALS AND METHODS: Sixty patients susp ected of having PE were prospectively evaluated with pulmonary angiogr aphy and contrast-enhanced electron-beam CT. Thirty-eight patients und erwent ventilation-perfusion (V-P [also known as V/Q]) scanning. The p ulmonary vasculature was divided into 12 anatomic zones. CT and angiog raphic findings were correlated on a patient-by-patient basis and for each vascular zone. RESULTS: Both studies were negative for BE in 36 p atients. Both studies were positive in 15 patients, with the site of t he emboli correlating well. Prospective sensitivity of CT was 65%; spe cificity, 97%; positive predictive value, 94%; and negative predictive value, 82%. After review of the nine discordant cases, sensitivity an d specificity approached 100% for clinically important acute PE. CT de picted central and peripheral emboli equally well. CT was more sensiti ve and specific than V-P scanning. CONCLUSION: Electron-beam CT is a s ensitive and specific noninvasive method for the diagnosis of PE. It h as the potential to replace V-P scanning as the primary screening exam ination for PE.