Contribution of Thoracic Angioscanner in the Diagnosis of Pulmonary Embolism: About 90 Cases at the Aristide Le Dantec Hospital of Dakar

Objective: to assess the contribution of angioscanner in suspected pulmonary embolism and compare the results with clinical scores. Patients and methods: this was a retrospective, cross-sectional study over 12 months (October 1, 2016 to September 30, 2017) in the imaging department of Aristide Le Dantec Hospital, including 90 patients. The average age was 48 years (extreme: 17 years and 86 years). The clinical probability of PE was intermediate in 52.2 % of patients and low in 45.5 % according to the revised Geneva score; intermediate in 26.6 % of patients and low in 73.3 % according to the Wells score. The examinations were performed with a Siemens 64 bar scanner with a Medrad Stellant automatic injector. Results: an endoluminal defect was found in 36 patients (40 %), truncular topography in 11 %, segmentary in 50 % and lobar in 39 %. PAH was noted in 58 % of these patients with reversal of the VD/VG ratio in 27.7 %. Pulmonary infarction was noted in 50 % of patients with PE with pleural effusion in 36.1 %. Alternative diagnoses found in 60 % of patients were dominated by pulmonary emphysema with 35.18 % of cases. For a low clinical probability according to the revised Geneva and Wells, angioscanner was positive in 24.39 % and 37.87 % respectively, compared to 53.19 % and 45.23 % for an intermediate score. Conclusion: angioscanning made it possible to diagnose PE in 40 % of patients and to assess the prognosis by studying the cardiac impact.