CTPA for the diagnosis of acute pulmonary embolism during pregnancy. Export

@article{citeulike:3292340, abstract = {CT pulmonary angiography (CTPA) has been suggested by the Fleischner society as the first test following a negative leg ultrasound in pregnant patients with suspected pulmonary embolism. This editorial discusses the use of CTPA as a diagnostic tool in pregnant women and comments on the need for specifically adapting CT protocols during pregnancy in the light of new research describing a substantial number of non-diagnostic examinations in pregnant women if routine scanning protocols are used for CTA of the pulmonary arteries. Potential reasons for these high numbers of insufficient examinations are physiological changes occurring during pregnancy that lead to a hyperdynamic circulation, which reduces average enhancement of the pulmonary vasculature. In addition, there are possible breathing-related effects that include an increased risk for Valsalva manoeuvre with devastating effects for pulmonary vascular enhancement. Techniques to overcome these problems are discussed: bolus triggering with short start delays, high flow rates or high contrast medium concentration, preferential use of fast CT systems and the use of low kVp CT techniques. CT data acquisition during deep inspiration should be avoided and shallow respiration may be considered as an alternative to suspended breathing in this patient group. All these factors can contribute to optimization of the quality of pulmonary CTA in pregnant patients. It is time now to adapt our protocols and provide optimum care for this sensitive patient group.}, address = {Department for Radiology, Academic Medical Center AMC, Meibergdreef 9, 1105 AZ Amsterdam, Amsterdam, Netherlands, cornelia.schaeferprokop@gmail.com.}, author = {Schaefer-Prokop, Cornelia and Prokop, Mathias}, citeulike-article-id = {3292340}, citeulike-linkout-0 = {http://dx.doi.org/10.1007/s00330-008-1158-8}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/18795302}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=18795302}, day = {16}, doi = {10.1007/s00330-008-1158-8}, issn = {0938-7994}, journal = {European radiology}, keywords = {angiogram, angiography, ct, ctpa, embolism, embolus, pregnancy, pulmonary}, month = {September}, posted-at = {2008-09-19 10:03:50}, priority = {2}, title = {CTPA for the diagnosis of acute pulmonary embolism during pregnancy.}, url = {http://dx.doi.org/10.1007/s00330-008-1158-8}, year = {2008} }

TY - JOUR ID - citeulike:3292340 L3 - citeulike-article-id:3292340 N2 - CT pulmonary angiography (CTPA) has been suggested by the Fleischner society as the first test following a negative leg ultrasound in pregnant patients with suspected pulmonary embolism. This editorial discusses the use of CTPA as a diagnostic tool in pregnant women and comments on the need for specifically adapting CT protocols during pregnancy in the light of new research describing a substantial number of non-diagnostic examinations in pregnant women if routine scanning protocols are used for CTA of the pulmonary arteries. Potential reasons for these high numbers of insufficient examinations are physiological changes occurring during pregnancy that lead to a hyperdynamic circulation, which reduces average enhancement of the pulmonary vasculature. In addition, there are possible breathing-related effects that include an increased risk for Valsalva manoeuvre with devastating effects for pulmonary vascular enhancement. Techniques to overcome these problems are discussed: bolus triggering with short start delays, high flow rates or high contrast medium concentration, preferential use of fast CT systems and the use of low kVp CT techniques. CT data acquisition during deep inspiration should be avoided and shallow respiration may be considered as an alternative to suspended breathing in this patient group. All these factors can contribute to optimization of the quality of pulmonary CTA in pregnant patients. It is time now to adapt our protocols and provide optimum care for this sensitive patient group. JF - European radiology SN - 0938-7994 AD - Department for Radiology, Academic Medical Center AMC, Meibergdreef 9, 1105 AZ Amsterdam, Amsterdam, Netherlands, cornelia.schaeferprokop@gmail.com. TI - CTPA for the diagnosis of acute pulmonary embolism during pregnancy. KW - angiogram KW - angiography KW - ct KW - ctpa KW - embolism KW - embolus KW - pregnancy KW - pulmonary AU - Schaefer-Prokop, Cornelia AU - Prokop, Mathias PY - 2008/09/16/ UR - http://dx.doi.org/10.1007/s00330-008-1158-8 ER -