Published Paper Details:

Background- The use of spiral computed tomography (CT) for the diagnosis of pulmonary embolism has been compared to angiography, the current gold standard. However, the accuracy of CT has never been evaluated against an independent gold standard. The aim of this study was to compare contrast-enhanced spiral CT to pulmonary angiography for the detection of sub segmental sized pulmonary emboli. Methods and materials- this is a retrospective observational study. Based on case records, 20 patients with acute pulmonary embolism were selected. After routine investigations, only if haemodynamically stable, Spiral CT was performed, followed by pulmonary angiography. Spiral CT and angiography were interpreted independently by two radiologists. Results- Majority of the patients presented with dyspnoea. Spiral CT was performed, and 16/20 patients had evidence of acute pulmonary embolus in the sub segmental vessels. It was sub-optimal in 4 patients. Sensitivity and specificity for CT and angiography, respectively, were: 88% vs 93.33%, 75% vs 82.42% respectively. Accuracy of CT and angiography was comparable; 75.09% vs 76.14%. Conclusion- There was no difference between spiral CT and angiography for detection of sub-segmental-sized pulmonary emboli. We conclude that spiral CT is comparable to angiography for detection of pulmonary emboli.