Accuracy of computed tomography angiography in the detection of pulmonary embolism in patients with high body weight.
Eur J Intern Med. 2014 Aug 29;
Authors: Megyeri B, Christe A, Schindera ST, Horkay E, Sikula J, Cullmann JL, Kollar J, Heverhagen JT, Szucs-Farkas Z
BACKGROUND: The accuracy of CT pulmonary angiography (CTPA) in detecting or excluding pulmonary embolism has not yet been assessed in patients with high body weight (BW).
METHODS: This retrospective study involved CTPAs of 114 patients weighing 75-99kg and those of 123 consecutive patients weighing 100-150kg. Three independent blinded radiologists analyzed all examinations in randomized order. Readers' data on pulmonary emboli were compared with a composite reference standard, comprising clinical probability, reference CTPA result, additional imaging when performed and 90-day follow-up. Results in both BW groups and in two body mass index (BMI) groups (BMI <30kg/m(2) and BMI ≥30kg/m(2), i.e., non-obese and obese patients) were compared.
RESULTS: The prevalence of pulmonary embolism was not significantly different in the BW groups (P=1.0). The reference CTPA result was positive in 23 of 114 patients in the 75-99kg group and in 25 of 123 patients in the ≥100kg group, respectively (odds ratio, 0.991; 95% confidence interval, 0.501 to 1.957; P=1.0). No pulmonary embolism-related death or venous thromboembolism occurred during follow-up. The mean accuracy of three readers was 91.5% in the 75-99kg group and 89.9% in the ≥100kg group (odds ratio, 1.207; 95% confidence interval, 0.451 to 3.255; P=0.495), and 89.9% in non-obese patients and 91.2% in obese patients (odds ratio, 0.853; 95% confidence interval, 0.317 to 2.319; P=0.816).
CONCLUSION: The diagnostic accuracy of CTPA in patients weighing 75-99kg or 100-150kg proved not to be significantly different.
PMID: 25179677 [PubMed - as supplied by publisher]