PURPOSE: It had been known that about 10% of acute pulmonary thromboembolism (APTE) was complicated with pulmonary infarctions. Recent multidetector computer tomography (MDCT) has enabled us to evaluate the images in detail. To clarify the frequency and the image characteristics of pulmonary infarction on MDCT.
METHODS: Between July 2001 and April 2009, 87 patients, who were diagnosed of APTE, were admitted to our hospital. Fifty-three patients ( average 52.4 ± 16.7 years old, 27 females), who were evaluated with MDCT(16 - slice or 64 - slice), were enrolled. We evaluated the frequency, the numbers, the location and the shape of pulmonary infarctions on MDCT and the contributing factors for the occurrence of pulmonary infarction.
RESULTS: Thirteen patients (24.5%) were complicated with pulmonary infarctions. Patients with pulmonary infarction were significantly older than those without pulmonary infarction (p< 0.05). Patients with pulmonary infarction had also the higher severity of APTE than those without pulmonary infarction (p< 0.005). MDCT showed higher frequency of pleural effusion in patients with pulmonary infarction than those without pulmonary infarction (p< 0.05). Of 13 patients with pulmonary infarction, 9 patients had one infarction, but 4 patients had multiple infarctions. The locations of pulmonary infarctions were located in right lung (n=19) more than in left lung (n=5). On MDCT, the images of pulmonary infarctions took various types, which were not wedge-shaped (n=10) but also non-wedge-shaped such as round-shape and infiltration - like (n=14).
CONCLUSION: In APTE patients, the frequency of pulmonary infarction on MDCT was higher compared with the frequency of previous reports. The forms of pulmonary infarction were various on MDCT.
CLINICAL IMPLICATIONS: We suggest that MDCT enables us to evaluate the images of pulmonary infarctions in detail. MDCT is a new tool for diagnosis of pulmonary infarction.
DISCLOSURE: Tsuji Akihiro, No Financial Disclosure Information; No Product/Research Disclosure Information