Frequency of Clinically Relevant Incidental Findings on Chest Computed Tomographic Angiograms Performed to Diagnose Pulmonary Embolism

Abstract

Background and Objective: Patients with symptoms of suspected pulmonary embolism (PE) who undergo
computed tomography (CT) pulmonary angiogram have other imaging findings in addition to PE in the
pulmonary circulation. The radiologists must pay attention to these incidental findings and report them rather
than just giving a positive or negative pulmonary angiogram report. Therefore, the objective of the study was
to determine the frequency of clinically relevant incidental findings on CT angiograms in patients with
suspected pulmonary embolism (PE).
Methods: It was a cross-sectional study conducted at the radiology Department of Hameed Lateef Hospital
from May to November 2023. The study included 133 patients of both genders, with suspected pulmonary
embolism. Patients with known tuberculosis, COPD, CRF and claustrophobia were excluded. Ensuring the
protocols of informed consent, CT angiography of the chest was performed with and without intravenous
contrast administration. The craniocaudal images at direction 25, 65, and 180 sec post-iodinated contrast
injection during single breath hold were obtained. Results were interpreted for any clinically relevant
incidental findings.
Results: Clinically relevant findings discovered incidentally in CT pulmonary angiograms were found in 78
(58.65%) patients. Of these, pulmonary nodule was found in 11 (14.10%), lymphadenopathy in 04 (5.13%),
pleural effusion in 34 (53.59%) and consolidation in 29 (37.18%) patients.
Conclusion: The frequency of incidental findings which are relevant clinically is quite high in chest CT
pulmonary angiograms performed to diagnose PE.
Key Words: Pulmonary Embolism, Incidental Findings, Computed Tomographic Angiograms