Computer-assisted detection of acute pulmonary embolism at CT pulmonary angiography in children and young adults: a diagnostic performance analysis.

Computer-assisted detection of acute pulmonary embolism at CT pulmonary angiography in children and young adults: a diagnostic performance analysis. Acta Radiol. 2018 Oct 30;:284185118808547 Authors: Tang CX, Zhou CS, Schoepf UJ, Mastrodicasa D, Duguay T, Cline A, Zhao YE, Lu L, Li X, Tao SM, Lu MJ, Lu GM, Zhang LJ Abstract BACKGROUND: To diagnose pulmonary embolism (PE) in children and adults since evaluating tiny pulmonary vasculature beyond segmental level is a challenging and demanding task with thousands of images. PURPOSE: To evaluate the effect of computer-assisted detection (CAD) on acute PE on CTPA in children and young adults by readers with varying experience levels. MATERIAL AND METHODS: Six radiologists were retrospectively divided into three groups according to experience levels and assessed the CTPA studies on a per-emboli basis. All readers identified independently the PE presence, and ranked diagnostic confidence on a 5-point scale with and without CAD. Reading time, sensitivities, specificities, accuracies, positive predictive values (PPVs), and negative predictive values (NPVs) were calculated for each reading. RESULTS: The sensitivities and NPVs differed significantly in most readers ( P = 0.004, 0.001, 0.010, 0.010, and 0.012 for sensitivities and P = 0.011, 0.003, 0.016, 0.017, and 0.019 for NPVs) except for reader 6 ( P = 0.148 and 0.165, respectively), and the accuracies of ...
Source: Acta Radiologica - Category: Radiology Authors: Tags: Acta Radiol Source Type: research

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CONCLUSIONS: The AADD cutoff results in a clinically non-significant decrease in QALY but important costs reductions. It is a decrementally cost-effective innovation, with a potential of cost savings of>$80 million per year for the United States healthcare system. PMID: 31925875 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - Category: Hematology Authors: Tags: J Thromb Haemost Source Type: research
Abstract Pulmonary embolism (PE) is a condition characterised by an obstruction of the pulmonary arterial system by one or more emboli. Advanced clinical practitioners are often faced with ruling out a diagnosis of PE in patients with non-specific symptoms such as dyspnoea and pleuritic chest pain, which can be fairly mild and therefore a diagnosis of PE easily missed. PEs can be a challenge to diagnose, especially in elderly people, since it can be difficult to differentiate their symptoms from other less serious illnesses. Widely used scoring tools are helpful to calculate a patient's probability of having a PE....
Source: British Journal of Nursing - Category: Nursing Authors: Tags: Br J Nurs Source Type: research
Abstract Background and Objectives: Inflammation is considered a risk factor for venous thromboembolism. The association between inflammatory markers and the severity of acute pulmonary embolism (APE) has not been explored. Methods: We studied the association between two crude markers of inflammation, serum albumin, and red cell distribution width (RDW) and massive versus non-massive APE. Results: Among 552 consecutive cases of CT-angiogram-confirmed APE, a total of 46 cases (8.3%) had massive APE. Despite similar demographics and comorbidities, patients with massive APE had higher frequency of acute kidney injury...
Source: Medicina (Kaunas) - Category: Universities & Medical Training Authors: Tags: Medicina (Kaunas) Source Type: research
ConclusionThe incidence of CTEPH observed in this study 1  year after the first episode of acute PE was approximately 6.9%. This incidence seems to be high in our population, and diagnostic and therapeutic strategies for the early identification of CTEPH are needed.
Source: Lung - Category: Respiratory Medicine Source Type: research
Conclusions: Pulmonary artery catheter-directed thrombolysis is a technically feasible therapeutic option for children and adolescents with submassive and massive pulmonary emboli.
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Online Clinical Investigations Source Type: research
This report describes a patient who was diagnosed with ABPA and soon developed PTE. Patient concerns: A 64-year-old man was diagnosed with ABPA in hospital for recurrent fever with cough. Two months later, the patient was readmitted to the hospital because of PTE. Diagnoses: ABPA was diagnosed during the first hospitalization, and laboratory tests showed an increase in serum IgE and Aspergillus fumigatus-specific IgG. Sputum culture suggested A. fumigatus and high-resolution computed tomography (HRCT) showed inflammation of both lungs and central bronchiectasis. During the second hospitalization, the patient's chest ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
We described the first 2 cases diagnosed with PAVM recanalization>10 years after the first catheter embolization. These cases suggest that patients with PAVMs should undergo life-long follow-up after catheter embolization.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Conclusion: Owing to the rarity of the disease and its non-specific clinical manifestations, approximately half of the PAIS cases are misdiagnosed or have a delayed diagnosis. Thus, improving our understanding of the disease and facilitating its early diagnosis are essential.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Abstract A 58-year-old male presented with a hemodynamically significant pulmonary embolism. Computed tomography angiogram revealed a saddle embolus in the main pulmonary artery with extensive clot burden affecting all lobes and right heart strain. Transthoracic echocardiogram displayed a dilated right ventricle with reduced systolic function. The patient was scheduled for pulmonary embolectomy. The intraoperative transesophageal echocardiogram (TEE) demonstrated a mobile left atrial thrombus that was missed on previous imaging. After removal of the thrombi, TEE showed a patent foramen ovale (PFO). The left atrial...
Source: Annals of Cardiac Anaesthesia - Category: Anesthesiology Authors: Tags: Ann Card Anaesth Source Type: research
The objective of this study was to determine whether clinical decision support (CDS) use would be associated with increased imaging yields after controlling for selection bias.MethodsWe performed a retrospective cohort study in the emergency departments of two tertiary care hospitals of all CTPAs performed between August 2015 and September 2018. Providers ordering a CTPA are routed to an optional CDS tool, which allows them to use Wells’ Criteria for pulmonary embolism. After propensity score matching, CTPA yield was calculated for the CDS-use and CDS-dismissal groups and stratified by provider type.ResultsA total of...
Source: Journal of the American College of Radiology - Category: Radiology Source Type: research
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