ROLE OF MULTIPLANAR REFORMATIONS IN DIAGNOSING PERIPHERAL PULMONARY EMBOLISM ON MULTIDETECTOR COMPUTED TOMOGRAPHY
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Objective: To evaluate the role of multiplanar reformations (MPR) in the diagnosis of peripheral pulmonary embolism on multidetector computed tomography (MDCT) pulmonary angiography.
Methodology: This was a retrospective cross sectional study carried out in Department of Radiology, Rehman Medical Institute, Peshawar from December 2012 to October 2017 on 437 patients with clinically suspected pulmonary embolism (PE). Age range was 20 to 90 years and patients presented with shortness of breath, nonspecific chest pain or pleuritic chest pain. CT pulmonary angiography (CTPA) was performed on 128 slice MDCT Toshiba scanner. Two sets of images were analyzed: overlapped axial sections and 2DMPR of obliquely oriented peripheral arteries.
Results: Peripheral PE was diagnosed in small segmental branches in 184 (42%) cases on MDCT pulmonary angiography. MPR detected peripheral PE in oblique oriented vessels. Associated central right main pulmonary artery thrombus was seen in 94 patients and in left pulmonary artery in 93 patients. The presence of central embolism was easily detected on axial overlapped images. The peripheral segmental emboli were further confirmed or excluded with MPR.
Conclusion: Multiplanar reformations enabled confident diagnosis of peripheral PE in 42% of cases. MDCT with MPR improves analysis of extent of thromboembolic disease and enables confident exclusion in inconclusive CT scans.
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