Accuracy of computed tomography angiography in the detection of pulmonary embolism in patients with high body weight

摘要

Background: The accuracy of CT pulmonary angiography (CTPA) in detecting or excluding pulmonary embolism has not yet been assessed in patients with high body weight (BW).Methods: This retrospective study involved CTPAs of 114 patientsweighing 7599 kg and those of 123 consecutive patients weighing 100150 kg. Three independent blinded radiologists analyzed all examinations in randomized order. Readers' data on pulmonary emboli were compared with a composite reference standard, comprising clinical probability, reference CTPA result, additional imaging when performed and 90-day follow-up. Results in both BW groups and in two body mass index (BMI) groups (BMI 30 kg/m2 and BMI ≥30 kg/m2, i.e., non-obese and obese patients) were compared.Results: The prevalence of pulmonary embolism was not significantly different in the BW groups (P = 1.0). The reference CTPA result was positive in 23 of 114 patients in the 7599 kg group and in 25 of 123 patients in the ≥100 kg group, respectively (odds ratio, 0.991; 95% confidence interval, 0.501 to 1.957; P= 1.0).No pulmonary embolism-related death or venous thromboembolism occurred during follow-up. The mean accuracy of three readers was 91.5% in the 7599 kg group and 89.9% in the ≥100 kg group (odds ratio, 1.207; 95% confidence interval, 0.451 to 3.255; P = 0.495), and 89.9% in non-obese patients and 91.2% in obese patients (odds ratio, 0.853; 95% confidence interval, 0.317 to 2.319; P = 0.816).Conclusion: The diagnostic accuracy of CTPA in patients weighing 7599 kg or 100150 kg proved not to be significantly different.