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'''Editors-in-Chief:''' [[C. Michael Gibson, M.S., M.D.]]  '''Associate Editor-In-Chief''': [[User:Ujjwal Rastogi|Ujjwal Rastogi, MBBS]] [mailto:urastogi@perfuse.org]
'''Editors-in-Chief:''' [[C. Michael Gibson, M.S., M.D.]]  '''Associate Editor-In-Chief''': [[User:Ujjwal Rastogi|Ujjwal Rastogi, MBBS]] [mailto:urastogi@perfuse.org]
{{Deep vein thrombosis}}
{{Deep vein thrombosis}}
==Overview==
==Overview==
More than 90% of all Pulmonary Embolism arise from thrombi within the large deep veins of the legs, typically the popliteal vein and the larger veins above it. Since Pulmonary embolism and deep vein thrombosis are different spectrum of the same disease, CT venography of the pelvis and lower extremities is often incorporated into the CT angiography PE protocol to identify or exclude concurrent deep venous thrombosis. <ref name="pmid15051664">{{cite journal| author=Kanne JP, Lalani TA| title=Role of computed tomography and magnetic resonance imaging for deep venous thrombosis and pulmonary embolism. | journal=Circulation | year= 2004 | volume= 109 | issue= 12 Suppl 1 | pages= I15-21 | pmid=15051664 | doi=10.1161/01.CIR.0000122871.86662.72 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15051664  }} </ref>
Venous thrombosis in the proximal deep veins is responsible for more than 90% of the [[pulmonary embolism]]s. Some of the investigators have suggested combined use of CT PE protocol and CT scan venography in cases of suspected [[DVT]] and [[PE]].<ref name="pmid15051664">{{cite journal| author=Kanne JP, Lalani TA| title=Role of computed tomography and magnetic resonance imaging for deep venous thrombosis and pulmonary embolism. | journal=Circulation | year= 2004 | volume= 109 | issue= 12 Suppl 1 | pages= I15-21 | pmid=15051664 | doi=10.1161/01.CIR.0000122871.86662.72 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15051664  }} </ref> However, it is not done routinely in clinical settings because of certain limitations:
* Side effects of IV contrast administration
* Expensive modality
 
 
==Uses==
 
It may be considered and is preferred over contrast [[Deep vein thrombosis venography|venography]] as there is no need to cannulate the foot veins, in the following setting:
* [[Deep vein thrombosis ultrasound|Compression ultrasonography]] is impractical because of excessive swelling, edema or leg cast, or nondiagnositc.


A study had showen that CTPA positively diagnosed acute PE, in 14% to 44% patient having non-diagnostic V/Q scan and with normal lower extremity ultrasound imaging. <ref name="pmid9356628">{{cite journal| author=Ferretti GR, Bosson JL, Buffaz PD, Ayanian D, Pison C, Blanc F et al.| title=Acute pulmonary embolism: role of helical CT in 164 patients with intermediate probability at ventilation-perfusion scintigraphy and normal results at duplex US of the legs. | journal=Radiology | year= 1997 | volume= 205 | issue= 2 | pages= 453-8 | pmid=9356628 | doi= | pmc= | url= }} </ref> Another randomized control trial involving seventy patients with clinically suspected pulmonary embolism, showed that, compared to sonography, CT venography in addition to CT pulmonary angiography is a relatively accurate method for evaluation of femoropopliteal venous thrombosis.<ref name="pmid11000152">{{cite journal| author=Garg K, Kemp JL, Wojcik D, Hoehn S, Johnston RJ, Macey LC et al.| title=Thromboembolic disease: comparison of combined CT pulmonary angiography and venography with bilateral leg sonography in 70 patients. | journal=AJR Am J Roentgenol | year= 2000 | volume= 175 | issue= 4 | pages= 997-1001 | pmid=11000152 | doi= | pmc= | url= }} </ref>


==References==
==References==

Revision as of 04:31, 17 May 2012

Editors-in-Chief: C. Michael Gibson, M.S., M.D. Associate Editor-In-Chief: Ujjwal Rastogi, MBBS [1]

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Overview

Venous thrombosis in the proximal deep veins is responsible for more than 90% of the pulmonary embolisms. Some of the investigators have suggested combined use of CT PE protocol and CT scan venography in cases of suspected DVT and PE.[1] However, it is not done routinely in clinical settings because of certain limitations:

  • Side effects of IV contrast administration
  • Expensive modality


Uses

It may be considered and is preferred over contrast venography as there is no need to cannulate the foot veins, in the following setting:


References

  1. Kanne JP, Lalani TA (2004). "Role of computed tomography and magnetic resonance imaging for deep venous thrombosis and pulmonary embolism". Circulation. 109 (12 Suppl 1): I15–21. doi:10.1161/01.CIR.0000122871.86662.72. PMID 15051664.