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European Radiology

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Open Access 01-03-2020 | Computed Tomography | Emergency Radiology

Pulmonary embolism during pregnancy: a 17-year single-center retrospective MDCT pulmonary angiography study

Authors: David C. Rotzinger, Vincent Dunet, Vesna Ilic, Olivier W. Hugli, Reto A. Meuli, Sabine Schmidt

Published in: European Radiology | Issue 3/2020

Abstract

Objectives

To determine the prevalence of pulmonary embolism (PE) and alternative diagnoses detected by computed tomography pulmonary angiography (CTPA) in pregnant women; and to assess changes over time regarding radiation dose, technical quality, and examination frequency.

Materials and methods

This retrospective study included all pregnant women referred for CTPA due to clinically suspected PE over 17 years. Two blinded radiologists reviewed the CTPAs in consensus with regard to PE, alternative diagnoses, and technical quality. We retrieved patient data regarding radiation dose metrics and associated clinical and laboratory parameters. Subgroup comparisons were performed (Wilcoxon and Kruskal-Wallis tests).

Results

Of the 237 identified patients, 8 (3.3%) were excluded due to inadequate technical CTPA quality, and 229 patients were analyzed (mean age, 31.7 years; mean gestational age, 28 ± 7 weeks). The four different CT systems used over the study period had similar technical quality (p = 0.28). Of 229 patients 16 (7%) patients had PE, 144 (62.9%) had no abnormal findings, and 69 (30.1%) had an alternative diagnosis (consolidation, other pulmonary opacities, pleural effusion, and basal atelectasis). Gestational age, symptoms, and D-dimer levels were not significantly different between patients with or without PE (p > 0.05). Over time, radiation dose exposure decreased by 30% (p < 0.001), while the number of annual examinations increased by > 4-folds.

Conclusions

In pregnant women, CTPA rarely indicates PE and more often shows alternative diagnoses. Over 17 years, the use of CTPA in pregnancy has notably increased, while the radiation dose exposure has decreased by one third.

Key Points

• The use of CTPA in pregnancy has steadily risen over the last 17 years

• In pregnant women, CTPA rarely reveals PE and more often shows alternative diagnoses

• Recent technical improvements have substantially decreased the radiation dose exposure inherent in CTPA without reducing diagnostic image quality

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Title: Pulmonary embolism during pregnancy: a 17-year single-center retrospective MDCT pulmonary angiography study
Authors: David C. Rotzinger
Vincent Dunet
Vesna Ilic
Olivier W. Hugli
Reto A. Meuli
Sabine Schmidt
Publication date: 01-03-2020
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Angiography
Computed Tomography
Published in: European Radiology / Issue 3/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-019-06501-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Pulmonary embolism during pregnancy: a 17-year single-center retrospective MDCT pulmonary angiography study

Abstract

Objectives

Materials and methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

Key Points

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