Pulmonary Embolism Clinical Trial
Official title:
Pulmonary Perfusion by Iodine Subtraction Mapping CT Angiography in Acute Pulmonary Embolism: a Diagnostic Accuracy Study Versus Pulmonary Perfusion SPECT.
- Pulmonary embolism (PE) is a diagnostic and therapeutic challenge. The risk of death of
untreated PE is approximately 25%. On the other hand, anticoagulant treatment is
associated with a haemorrhagic risk (2% of major haemorrhagic accidents per year, of
which 10% are fatal). A diagnostic accuracy is therefore necessary.
- Two approaches are available to diagnose PE:
1. A functional approach, represented by pulmonary ventilation / perfusion
scintigraphy (V / P), which looks for the functional consequences of PE. The main
disadvantage of this approach is that there is a high rate of non-diagnostic
examinations. On the other hand, it allows a mapping of pulmonary perfusion at the
microcapillary scale, and thus allows the quantification of the vascular
obstruction index, which would be an independent risk factor of PE recurrence.
2. A morphological approach, represented by CT pulmonary angiography (CTPA), which
allows the visualisation of the clot itself. This approach is currently the most
used but has some limitations, including a risk of over-diagnosis of pulmonary
embolism and the inability to reliably quantify the index of vascular obstruction.
Lung subtraction iodine mapping CT is a new technique allowing, during the realization of a
CTPA, without additional irradiation, to provide a mapping of the iodine. This mapping of
iodine could potentially be used to evaluate pulmonary perfusion.
It would then be possible to obtain, during a single examination, in addition to the
anatomical information of the thoracic angioscan, information on the pulmonary perfusion and
thus to assess the functional consequences of PE.
No study to date has evaluated the performance of the pulmonary subtraction CT for the
evaluation of pulmonary perfusion in the context of acute pulmonary embolism suspicion.
n/a
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