New Technology Of Spiral CT Pulmonary Angiography In The Diagnosis Of Pulmonary Embolism

Purpose To evaluation of the value of computer-aided detection (CAD) technology inthe CT diagnosis of pulmonary embolism pulmonary angiography. Materials andMethods The records of279consecutive patients (159male,120female, medianage58years) diagnosed or suspected of having PE and/or deep venous thromobsiswho underwent CT pulmonary angiography between July2010and December2010were reviewed. The position, number of embolus were detected by two doctors wholack of experience, and then the same doctors did this work again assisted by CADafter three months ago. All CTPA images were evaluated by three experienced doctors(with respectively8years,10years and15years experience in thoracic radiology) asthe reference standard. Both from patients and embolus, evaluation the accuracy ofthe doctors who lack of experience in diagnose PE with and without CAD. Statisticalanalysis used SPSS11.5statistical package. Results A total of267patients wereenrolled in this study. There were81patients and555embolus (trunk26, leaves73,segment254, subsegmental202)detected by the experience doctors. And67patientsand493embolus were detected by the lack of experience doctors without CAD, thesensitivity were82.7%and88.8%for patients and embolus, diagnostic sensitivity oflevels in the pulmonary artery (trunk, leaves, segmentd and subsegmental) were100%(26/26),98.6%(72/73),89.8%(228/254),82.7%(167/202);75patients and523embolus were detected by the lack of experience doctors with CAD respectively, thesensitivity were92.6%and94.2%for patients and embolus, diagnostic sensitivity oflevels in the pulmonary artery (trunk, leaves, segmented and subsegmental) were 100%(26/26),100%(73/73),92.1%(234/254),94.1%(190/202); And67patients and305embolus were detected by CAD, the sensitivity were82.7%and55.0%forpatients and embolus, diagnostic sensitivity of levels in the pulmonary artery (trunk,leaves, segmentd and subsegmental) were11.5%（3/26）、35.6%（26/73）、53.9%（137/254）、68.8%（139/202）. There were6patients with PE detected by the lack ofexperience doctors with CAD, but without CAD. Conclusion Our results suggest thatCAD significantly improves the sensitivity for the doctors who lack of experience indetection of PE, especially for the subsegmental thrombus. Meanwhile, we shouldstrictly control the CTPA images influenced by the image quality because thediagnosis of CAD.