The diagnosis is made by a positive PCR test, which is highly specific. Adherence to local Hospital protocol. Yet, chest CT is often used in patients with known or suspected COVID-19 due to regional preferences, lack of … RECIST 1.1 - examples; RECIST 1.1 - and more; RECIST 1.1 - the basics; COVID-19 Imaging findings . Radiology and hospital information database was utilized to identify patients that underwent CTPA between 2016 and 2018 meeting the inclusion/exclusion criteria. Patients undergoing CTPA before (phase 1 group) or after (phase 2 group) the protocol change, were assessed. Schembri GP, Miller AE, Smart R. Radiation dosimetry and safety issues in the investigation of pulmonary embolism. Downloads. Mandatory adherence to diagnostic protocol increases the yield of CTPA for pulmonary embolism Insights Imaging. 73 Patients who had a CTPA over a two-month period (February & March 2015) were identi-fied from the radiology records . Approximately 10 million patients present to emergency departments each year with symptoms raising concern of thromboembolism (VTE).1 The current gold standard for diagnosis of VTE is pulmonary angiography.2 As this study is invasive, alternative imaging protocols have been sought. Technique used for CTPA. Although the split-bolus injection protocols may appear sophisticated and complex in theory, in practice it can be stored on the injector system and selected from the menu of the stored protocol. 1 Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim ... . CT attenuation coefficients were measured in Hounsfield Units (HU) using regions of interest at the level of the pulmonary trunk. Quantitative noise was lower in the phase 1 group (p<0.001). Insights Imaging. Pulmonary embolism (PE) is a common condition with high mortality and morbidity. Walen S(1), de Boer E(2), Edens MA(3), van der Worp CA(2), Boomsma MF(2), van den Berg JW(4). gantry rotation time. CTPA exposes patients to a small, but not negligible, amount of radiation, which has recently raised concern in view of the increasing demand in CTPA performances. Question 2: The A1 segment of the RUL is the _____ segment. Correspondence afp@racgp.org.au. RESULTS: Effective dose was lower in the phase 2 group (0.95 v 1.66 mSv; p<0.001). Inclusion criterion was patients getting CTPA exam to rule out PE. • Mandatory adherence to diagnostic protocol increases the yield of CTPA for PE • Previous DVT and signs of DVT were associated with a higher yield • No patients with a low Wells score and a low D-dimer had PE. Protocol released - please contact your local representative or TPD. CTPA examinations were obtained in a multidetector CT scanner (Discovery CT750 HD, GE Healthcare) by using a dual-energy CTPA protocol (Gemstone Spectral Imaging GSI), with the following parameters: tube voltage 80–140 kV, 340 mA, pitch = 0.984, rotation time = 0.5 s, field of view = 512 mm × 512 mm, 64 × 0.625-mm detector configuration, and slice thickness = 1.25 mm. 2–4 CTPA is a standard procedure that obtains a CT volume while intravenously injected iodinated contrast media (CM) opacifies the pulmonary arteries. CTPA is fast and generally well tolerated ... Matthews S. Imaging pulmonary embolism in pregnancy: what is the most appropriate imaging protocol? The purpose of this study is to evaluate three injection protocols for CTPA to improve the image quality of rPA. MATERIALS AND METHODS: 24 consecutive patients suspected PE underwent CTPAs using a 64-detector MDCT. 13 Semin Nucl Med 2010;40:442–54. Radiology Tutorials; Radiology Department; School Of Medicine; CT Pulmonary Angiography > Quiz. Mandatory adherence to diagnostic protocol increases the yield of CTPA for pulmonary embolism. For CTPA at our institution, we use a 16 or 64-detector CT scanner. Br J Radiol 2006;79:441–44. Reverse-transcription polymerase chain reaction (RT-PCR) assay is the preferred method of diagnosis of COVID-19 infection. Methods: We will search PubMed, EMBASE, Web of Science, and Google Scholar from inception to October 1, 2018. Since CTPA is the first imaging modality in detecting PE in susceptible patients, ... All images were obtained using a 128-section multi-detector CT scanner based on the standard CTPA protocol for PE (detector width 40 mm, section thickness 0.625, rotation time 0.4 sec, 120 kVp, and 380 mAs) and 20 s after administration of 100 ml contrast media at a rate of 5 ml/sec. The role of diagnostic imaging in PE is being increasingly undertaken by computed tomography pulmonary angiography (CTPA). A CTPA is performed in the radiology department scanning room, with the patient lying flat (supine) ... A CTPA scan is a useful investigation for those patients with a moderate to high probablity of pulmonary embolism. This study shows that CTPA has high diagnostic yield in the diagnosis of pulmonary embolism, hence justifying its appropriateness as a routine imaging modality. 1), CTPA is the investigation of choice in patients with a high clinical suspicion of pulmonary embolus and in those with pre-existing pulmonary disease. In addition, dose models in the literature do not account for state-of-the-art low dose CT protocols utilizing tube current modulation of mA and kV, which significantly lower the dose of CTPA while preserving diagnostic accuracy. The model was scanned with 128-slice dual-source CT with slice thickness of 1 and 0.5 mm reconstruction interval. Protocol changes included: decreased kVp; increased contrast injection rate; imaging after shallow inspiration. CTPA Post-Test. Mean effective dose was 2.8±2.6 mSv and 13.5±7.8 mSv for CTPA and triple rule-out protocols, respectively. Radiology Tutorials; Radiology Department; School Of Medicine; CT Pulmonary Angiography > Pulmonary Embolus > Technique. Survey Results. Results Of 250 scans, 74 were positive (29.6 % [95 % CI, 24.3-35.5 %]) and 175 were negative (70 %). We use a collimation of 1.25 mm with a beam pitch of 1.35 (slice pitch 10.8; US Mode) and 0.5 sec. Further imaging may be necessary, either repeating CTPA with an increased delay or pulmonary angiography. 1,2 Since the 1990s, CT pulmonary angiography (CTPA) has become the method of choice for imaging in suspected PE. A total of 160 CTPA examinations (80 using each protocol) performed between January 2010 and February 2011 were assessed retrospectively. CT Protocols. + Learn More. COVID-19 is a viral disease also known as SARS-CoV-2 or severe acute respiratory syndrome coronavirus 2. Utilisation of CTPA in PE. Odds ratios were calculated as a measure of association between dichotomous variables and CTPA findings. This article discusses a hot topic on double low-dose protocol of computed tomography pulmonary angiography (CTPA) in the diagnosis of pulmonary embolism, with a special focus on a recent paper published in the British Journal of Radiology about the feasibility of this technique. Insights Imaging 2014;5(2):231–236). 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