The value of hyperdense lumen sign at non-contrast Computed Tomography in the diagnostic work up of Pulmonary Embolism
Shafik, S., Said, A., Ali, F. (2023). The value of hyperdense lumen sign at non-contrast Computed Tomography in the diagnostic work up of Pulmonary Embolism. EKB Journal Management System, 4(2), 55-62. doi: 10.21608/ejmr.2023.188029.1322
Samuel Magdy Shafik; Ahmed Hesham Mohamed Said; Faten Mohamed Ali. "The value of hyperdense lumen sign at non-contrast Computed Tomography in the diagnostic work up of Pulmonary Embolism". EKB Journal Management System, 4, 2, 2023, 55-62. doi: 10.21608/ejmr.2023.188029.1322
Shafik, S., Said, A., Ali, F. (2023). 'The value of hyperdense lumen sign at non-contrast Computed Tomography in the diagnostic work up of Pulmonary Embolism', EKB Journal Management System, 4(2), pp. 55-62. doi: 10.21608/ejmr.2023.188029.1322
Shafik, S., Said, A., Ali, F. The value of hyperdense lumen sign at non-contrast Computed Tomography in the diagnostic work up of Pulmonary Embolism. EKB Journal Management System, 2023; 4(2): 55-62. doi: 10.21608/ejmr.2023.188029.1322

The value of hyperdense lumen sign at non-contrast Computed Tomography in the diagnostic work up of Pulmonary Embolism

Egyptian Journal of Medical Research
Volume 4, Issue 2, April 2023, Page 55-62  XML PDF (503.84 K)
Document Type: Original Article
DOI: 10.21608/ejmr.2023.188029.1322
View on SCiNiTO View on SCiNiTO
Authors
Samuel Magdy Shafik email ; Ahmed Hesham Mohamed Said; Faten Mohamed Ali
Radiology department, Faculty of Medicine, Beni Suef University, Egypt
Abstract
Background; It is possible to identify high-attenuation clots in pulmonary thromboembolism using non-contrast computed tomography (CT) of the chest. Such detection may be crucial for timely initiation of appropriate therapy. Aim and objectives; the aim of this study was to show the accuracy and usefulness of non-contrast CT in diagnosis of pulmonary embolism. Subjects and methods: The study was conducted in the Radiology Department at Beni-Suef University hospital to evaluate the role of non-contrast multi-slice computed tomography (MSCT) in detection of central pulmonary embolism using 16 slice MDCT. Result; hyperdense lumen sign shows an overall sensitivity of 50%, specificity of 100%, PPV (positive predictive value) of 100% while the NPV (negative predictive value) was 65.4%, having diagnostic value in detection of emboli which are located within the main pulmonary arteries, and the high-attenuated emboli (hyper-dense sign) in pulmonary artery had a sensitivity of 50 % and regarding the specificity was 100% for diagnosis of PE. Conclusion:  Positive hyper dense lumen sign can be prominent indicator of thrombus, which can be relied upon if (Computed Tomography Pulmonary Angiography) CTPA is not possible.
Keywords
hyperdense lumen sign; pulmonary embolism; non-contrast multi-slice computed tomography
References
  1. Giuntini C, Ricco Gd, Marini C, Melillo E, Palla A. Pulmonary embolism: epidemiology. Chest 1995; 107(Suppl): 3S–9S.
  2. Rohacek M, Buatsi J, Szucs-Farkas Z, Kleim B, Zimmermann H, Exadaktylos A, et al. Ordering CT pulmonary angiography to exclude pulmonary embolism: defense versus evidence in the emergency room. Intensive Care Med. 2012; 38:1345–51.
  3. Rosenow EC. Venous and pulmonary thromboembolism: An algorithmic approach to diagnosis and management. Mayo Clinic proc, 1995; 70: 45-49.
  4. Remy-Jardin M, Louvegny S, Remy J. Acute central thromboembolic disease: post therapeutic follow-up with spiral CT angiography. Radiology, 1997; 203:173-180.
  5. Gruettner J, Viergutz T, Bolte M, Henzler T, Schoenberg SO, Sudarski S, et al. Importance of risk factors for the evaluation of patients with a suspected pulmonary embolism. Exp Ther Med. 2015; 9:2281–4.
  6. Tatco V, Piedad H. The validity of hyperdense lumen sign in non-contrast chest CT scans in the detection of pulmonary thromboembolism. Int J Cardiovasc Imaging, 2011; 27(3):433–440
  7. Chiao-Hsuan C, Fu-Chieh S, Chin-Yu C, Chia-Hui C, Wan-Ling W, Chee-Wai M. Unenhanced multidetector computed tomography findings in acute central pulmonary embolism. BMC Medical Imaging volume 19, Article number, 2019: 65
  8. Perrier A, Roy PM, Sanchez O, Le Gal G, Meyer G. Multidetector-row computed tomography in suspected pulmonary embolism. New England Journal of Medicine, 2005; 352.17: 1760-1768.‏
  9. Van Belle A, Buller HR, Huisman MV. Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, nd computed tomography. JAMA, 2006; 295:172-179.
  10. Crichlow, Amanda; Cuker, Adam; Mills, Angela M. Overuse of computed tomography pulmonary angiography in the evaluation of patients with suspected pulmonary embolism in the emergency department. Academic Emergency Medicine, 2012; 19(11): 1219-1226.‏
  11. Tambe J, Moifo B, Fongang E, Guegang E. Acute pulmonary embolism in the era of multi-detector CT: a reality in sub-Saharan Africa. BMC medical imaging, 2012; 12.1: 31.‏
  12. Pulido L, Grossman S, Smith EB. Clinical presentation of pulmonary embolus after Total Joint Arthroplasty: Do size and location of embolus matter American Journal of Orthopedics, 2010; 39(4): 185 – 189.
  13. Mohamed N, Othman M, Hassan L, Yousef H. The accuracy of non-contrast chest computed tomographic scan in the detection of pulmonary thromboembolism. J Curr Med Res Pract, 2019; 4(1):61–66.
 

Statistics
Article View: 307
PDF Download: 179