Prevalence of Non-thromboembolic Incidental Findings on CT Pulmonary Angiography in a Tertiary Care Hospital
Quratulain Haroon
Department of Radiology, Liaquat National Hospital, Karachi, Pakistan.
Imtiaz Ali Panhwar *
Department of Radiology, Liaquat National Hospital, Karachi, Pakistan.
Rida Zainab
Department of Radiology, Liaquat National Hospital, Karachi, Pakistan.
Saleha Anwar
Department of Radiology, Liaquat National Hospital, Karachi, Pakistan.
Ashok Kumar
Department of Radiology, Liaquat National Hospital, Karachi, Pakistan.
Sadaf Nasir
Department of Radiology, Liaquat National Hospital, Karachi, Pakistan.
*Author to whom correspondence should be addressed.
Abstract
Objective: To assess the prevalence of clinically significant and insignificant incidental findings that had therapeutic consequences at the department of radiology in tertiary care academic hospital.
Study Design and Methodology: This is a retrospective study. All patients undergoing CTPA at Liaquat National Hospital Karachi during a period of two years from January 2019 to December 2020, were included in the study. Radiology data was extracted from our institution’s PACS software (OSIRIX) and was reported by an experienced radiologist in department of radiology at Liaquat National hospital Karachi. We measured the prevalence of non PE significant and insignificant incidental findings and placed them into the following 3 categories. 1) Findings that explained the patient’s acute symptoms, (2) incidental findings that required radiologic follow-up, and (3) other findings that did not require follow-up.
Results: There were 54% patients with age ≤35 years and 46% with age >35 years. Their gender distribution was noted as 49.8% males and 50.2% females. The incidental findings were noted as infiltrates (37%), pleural effusion (43.7%), pneumothorax (2.6%), pneumomediastinum (0.3%), pericardial effusion (4.2%), lymph nodes (53.7%), malignancy (8.7%), emphysema (11.3%), intra-abdominal pathology (45.3%), P.E positive (14.5%), consolidation (22.8%), bronchiectasis(7.1%), pulmonary edema (1.9%) and musculoskeletal injury (4.2%).
Conclusion: In patients with suspected pulmonary embolism, a wide range of incidental findings and simultaneous pathologies can be seen in CTPA. Therefore, the use of clinical algorithms is necessary for more definite approach to differential diagnoses of pulmonary embolism.
Keywords: CT pulmonary angiography, incidental findings, pulmonary embolism, conventional pulmonary angiography, pleural effusion
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