Ancillary findings on CT pulmonary angiograms and abnormalities on chest radiographs in patients in whom pulmonary embolism was excluded

Abstract

Users of CT pulmonary angiography recognized that ancillary findings on CT pulmonary angiograms of patients in whom PE was excluded often provided useful information.1-5 Some ancillary findings on the CT angiogram, such as peripheral wedge-shaped densities, may suggest the need for further studies of PE because they suggest peripheral PE in the absence of direct visualization of an intraluminal thrombus.4,6 The extent to which such ancillary findings shown on CT angiograms are also shown on the plain chest radiograph, and whether the chest radiograph would contribute additional information or should be entirely supplanted by CT angiography is not known. Medicare claims of 220 961 patients with suspected acute PE in 2005 showed that 71.5% had a chest radiograph obtained on the same day as PE was diagnosed or evaluated.7 It is not known whether plain chest radiographs of patients in whom PE is excluded show parenchymal or pleural abnormalities not shown as ancillary findings on the CT pulmonary angiogram. The purpose of this investigation is to test the hypothesis that plain chest radiographs may identify some abnormalities not shown as ancillary findings on CT pulmonary angiograms of patients in whom PE was excluded. © SAGE Publications 2012.