Authors' objectives:

This review aims to assess the available evidence on contrast-enhanced helical computed tomography for the diagnosis of pulmonary embolism.

Authors' recommendations: With regard to the use of contrast-enhanced helical computed tomography (CT) for the diagnosis of pulmonary embolism (PE), the ICSI Technology Assessment Committee finds: - All forms of CT are safe. - Conventional CT is not indicated in the diagnosis of PE. - Contrast-enhanced helical CT has good diagnostic accuracy (sensitivity of 70% to 100%; specificity of 78% to 97%) and higher sensitivity and interobserver agreement than ventilation/perfusion (V/Q) scanning. Reported accuracies are highly dependent on proper technique and accurate assessment by experienced radiologists. - Compared to pulmonary angiography (PA) and V/Q scanning, the reduced time required for and less invasive nature of contrast-enhanced helical CT would appear to be beneficial for the critically ill patient. For institutions with 24-hour expert interpretation of contrast-enhanced helical CT, full time access to helical CT may provide an advantage over other techniques. - Information from CT led to alternative diagnoses in over 50% of patients (Conclusion Grade II).

Authors' methods: Review

Project Status: Completed

URL for project: http://www.icsi.org/index.asp

Year Published: 2003

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Institute for Clinical Systems Improvement

Contact Address: 8009 34th Avenue South, Suite 1200, Bloomington, MN, USA. Tel: +1 952 814 7060; Fax: +1 952 858 9675

Contact Name: icsi.info@icsi.org

Contact Email: icsi.info@icsi.org

Copyright: Institute for Clinical Systems Improvement (ICSI)