PRIMARY DIAGNOSIS AND FOLLOW-UP OF ACUTE PULMONARY EMBOLI - COMPARISON BETWEEN DIGITAL SUBTRACTION ANGIOGRAPHY AND SPIRAL CT

The aim of this prospective study was to evaluate Spiral CT in the pri mary diagnosis of acute pulmonary emboli and for follow-up after throm bolytic treatment. Digital subtraction angiography of the lung was use d as the reference method. 38 patients were subjected to both procedur es. 79% of Spiral CT and 63% of DSA examinations were optimal. The two methods agreed in the diagnosis of thrombo-embolism in 30 patients an d excluded it in eight patients. Spiral CT verified thrombi in a total of 213 cases; of these 23 were in a main pulmonary artery (11%), 88 i n lobar arteries (41%), and 102 in segmental arteries (48%). DSA demon strated 180 thrombi. 17% of the adherent and partially occlusive throm bi were not shown. 38 pulmonary infarcts were found in 18 patients. In 15 patients resolution of thrombi following thrombolytic treatment wa s shown by Spiral CT. Spiral CT is an excellent alternative to DSA and its use in the diagnosis of pulmonary emboli is entirely appropriate.