Incidence of pulmonary embolism and other chest findings in younger patients using multidetector computed tomography.

BACKGROUND

Multidetector computed tomography (MDCT) has become the first-line modality for imaging patients with suspected pulmonary embolism (PE). The disadvantages of MDCT, the use of ionizing radiation and iodinated contrast agents, are a reasonable cause of concern, especially in young patients, and therefore it is critical to understand the likelihood of PE in these patients to evaluate a risk benefit analysis.

PURPOSE: To calculate the incidence of PE and other chest findings on MDCT in a young adult population investigated for PE.

MATERIAL AND

METHODS

387 consecutive patients (age 31.5+/-13.5 years) underwent chest MDCT for clinically suspected PE between January 2004 and August 2006. Incidence of PE and other chest findings were calculated with a confidence interval of 95% using binomial distribution.

RESULTS

PE incidence was 5%; negative PE with other chest findings was 60%. In 89% of the patients with other chest findings, these included findings of the pleura and/or lung parenchyma. The main patterns of disease were lung opacification suggesting pneumonia (41%), atelectasis (12.4%), and nodular/mass findings (17.5%). In 34% of the patients, there was no PE and no other findings present.

CONCLUSION

There is a low incidence of PE in young patients imaged for PE with MDCT.