A RETROSPECTIVE STUDY OF CT IMAGING OF PULMONARY EMBOLISM IN PATIENTS WITH COVID-19 PNEUMONIA USING DUAL ENERGY CT

Noorfizura, Ahmad and Yiaw, Yeong Huei and Yew, Ting Ting and Lim, Aun Nee (2023) A RETROSPECTIVE STUDY OF CT IMAGING OF PULMONARY EMBOLISM IN PATIENTS WITH COVID-19 PNEUMONIA USING DUAL ENERGY CT. In: Malaysian Congress of Radiology 2023, 21-23 July 2023, Kuala Lumpur.

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Abstract

Background Pulmonary Embolism(PE) is a known complication of COVID-19, and CT pulmonary angiography (CTPA) is commonly recommended for its detection. DECT offers additional value in diagnosing COVID-19 and its complications, particularly in detecting small pulmonary emboli. The aimed of this study is to assess the presence of PE , to determine the location of the thrombus and assess the utility of iodine density mapping in evaluating embolism with DECT. Methodology Retrospective study from May until September 2021 conducted on 163 patients with COVID-19 infection (positive PCR) and suspected PE. Results 163 patients PE suspicions with confirmed COVID-19 underwent CTPA. 19 patients were diagnosed with PE with a predominant segmental distribution. All the PE positive patients showed increased in D-Dimer value. Interestingly, four cases initially interpreted as PE negative by the previous radiologist were later found to be PE positive. The study found no significant difference in detecting pulmonary embolism between the conventional algorithm and dual-source energy reconstruction. However, DECT demonstrated practical advantages over conventional CTPA in detecting acute PE. Conclusion Currently, DECT is not considered a routine diagnostic procedure for evaluating PE according to guidelines. However, with increasing familiarity among radiologists and adjustments in image acquisition and post￾processing methods, the application of DECT for PE evaluation could expand. This could lead to the recognition of its benefits and the potential to enhance the detection and confident diagnosis of pulmonary embolism.

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