Incidental findings in patients who underwent computed tomography angiography with a preliminary diagnosis of pulmonary embolism

Abstract

Aims: The aim of this study was to investigate the contribution of incidental findings to the diagnosis in patients who underwent computed tomography pulmonary angiography (CTPA) with a preliminary diagnosis of pulmonary embolism (PE). Methods: In this retrospective study, 266 patients who underwent CT imaging with the diagnosis of PE between 01.01.2025 and 08.08.2025 were evaluated. After evaluating the presence of PE, the CTA images were evaluated for incidental findings. Incidental findings were reported in three categories (Type 1: Life-threatening or requiring rapid treatment, Type 2: Findings with potential for morbidity requiring specific action on follow-up, Type 3: Benign processes of limited clinical significance). Results: In this study, the number of patients diagnosed with PE was 27 (10.2%), while the number of patients diagnosed with bilateral PE was 7 (2.6%). Only 18 (6.8%) patients had no incidental findings. No significant difference is found in the ratio of incidental findings regarding gender (p=0.227). When we divided the incidental findings into groups, there were 90 (33.8%) patients in type 1, 124 (46.6%) patients in type 2, and 215 (80.8%) patients in type 3. The most common incidental findings were pneumonia in type 1, enlarged mediastinal lymph nodes in type 2, and fibroatelectatic changes in type 3. Particularly, the number of patients in type 1 (life-threatening or requiring rapid treatment) reveals the importance of incidental findings in patients examined with a preliminary diagnosis of PE. Conclusion: In patients with suspected PE, CTPA may indicate an important alternative diagnosis other than PE.

Keywords

• Pulmonary embolism
• computed tomography pulmonary angiography
• incidental findings

Pulmoner emboli ön tanısıyla bilgisayarlı tomografi anjiyografisi yapılan hastalarda rastlantısal bulgular

Abstract

Amaçlar: Bu çalışmanın amacı, pulmoner emboli (PE) ön tanısıyla bilgisayarlı tomografi pulmoner anjiyografi (BTPA) uygulanan hastalarda tesadüfi bulguların tanıya katkısını araştırmaktır. Yöntemler: Bu retrospektif çalışmada, 01.01.2025 ile 08.08.2025 tarihleri arasında PE tanısıyla BT görüntülemesi yapılan 266 hasta değerlendirildi. PE varlığı değerlendirildikten sonra, BTTA görüntüleri tesadüfi bulgular açısından değerlendirildi. Tesadüfi bulgular üç kategoride rapor edildi (Tip 1: Hayatı tehdit eden veya hızlı tedavi gerektiren, Tip 2: Takipte spesifik müdahale gerektiren morbidite potansiyeli olan bulgular, Tip 3: Sınırlı klinik öneme sahip iyi huylu süreçler). Bulgular: Bu çalışmada PE tanısı alan hasta sayısı 27 (%10,2) iken, bilateral PE tanısı alan hasta sayısı 7 (%2,6) idi. Sadece 18 (%6,8) hastada rastlantısal bulgu yoktu. Cinsiyete göre rastlantısal bulgu oranında anlamlı fark bulunmadı (p=0,227). Rastlantısal bulguları gruplara ayırdığımızda, tip 1'de 90 (%33,8), tip 2'de 124 (%46,6) ve tip 3'te 215 (%80,8) hasta vardı. En sık rastlantısal bulgular tip 1'de pnömoni, tip 2'de büyümüş mediastinal lenf nodları ve tip 3'te fibroatelektatik değişikliklerdi. Özellikle tip 1'deki hasta sayısı (hayatı tehdit eden veya acil tedavi gerektiren) PE ön tanısıyla incelenen hastalarda rastlantısal bulguların önemini ortaya koymaktadır. Sonuç: Pulmoner emboli şüphesi olan hastalarda, bilgisayarlı tomografi pulmoner anjiyografi PE dışında önemli bir alternatif tanıya işaret edebilir.

Keywords

• Pulmoner emboli
• bilgisayarlı tomografi pulmoner anjiyografi
• insidental bulgular

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