İbrahim SOMUNCU, Mustafa TAŞAR, Fatih ÖRS, Bahri ÜSTÜNSÖZ, Abdullah KOYUNCU, Arzu BALKAN, Ömer DENİZ, Uğur BOZLAR

Venöz tromboembolizm tanısında tek detektör sıralı ve çok detektör sıralı BT anjiyografi

Bu çalışmanın amacı, venöz tromboemboli (VTE) tanısında tek detektör sıralı BT (TDBT) ve çok detektör sıralı BT (ÇDBT) ile yapılan pulmoner BT anjiyografi incelemelerinin tanı değerlerinin belirlenmesidir. VTE şüphesi nedeniyle ventilasyon/perfüzyon sintigrafisi yapılmış 54 olgunun 36’sına TDBT, 18’ine ise ÇDBT ile pulmoner BT anjiyografi incelemesi yapıldı. Ayrıca, 16 olgu diğer incelemelere ek olarak pulmoner dijital substraksiyon anjiyografiyle de değerlendirildi. İstatistiksel analizler olguların son klinik tanıları ile karşılaştırılarak yapıldı. Çalışmaya dahil edilen 54 olgunun 26’sı son tanı olarak VTE tanısı aldı. Yirmisekiz olguda ise VTE tanısı dışlandı. VTE tanısı alan 26 olgunun 16’sı TDBT ile, 10’u ise ÇDBT ile taranan gruptaydı ve her iki modaliteyle de yanlış negatif sonuç saptanmadı. TDBT ile yapılan pulmoner BT anjiyografi ile bir olguya yanlış pozitif tanı konulurken, ÇDBT ile yapılan pulmoner BT anjiyografide yanlış pozitif tanı yoktu (her iki inceleme için duyarlılık %100, özgüllük sırasıyla %96 ve %100). TDBT ile yapılan pulmoner BT anjiyografi ile saptanan toplam embolilerin %9’u subsegmenter arterlerde iken, ÇDBT ile saptanan toplam embolilerin %24’ü subsegmenter arterlerdeydi. VTE tanısında hem TDBT hem de ÇDBT ile yapılan pulmoner BT anjiyografi güvenilirliği yüksek bir testtir. Subsegmental tromboembolilerin tespit edilmesinde ÇDBT ile yapılan pulmoner BT anjiyografi, TDBT ile yapılan pulmoner BT anjiyografiden daha üstündür.

Diagnosis of venous thromboembolism by single-detector row and multi-detector row CT angiography

Aim of this study is to determine the diagnostic value of pulmonary angiography performed by either single-detector row CT (SDCT) or multi-detector row CT (MDCT) in patients suspected of venous thromboembolism (VTE). SDCT was performed on 36 and MDCT on 18 of total of 54 patients on whom V/Q scintigraphy was obtained with a suspicion of VTE. Sixteen out of 54 cases got additional pulmonary DSA. Statistical analyses were based on final clinical diagnoses of the individual cases. Twenty-six out of 54 cases in the study got the final diagnoses of VTE and VTE was certainly excluded in the remaining 28. Sixteen out of true 26 VTE cases were in the SDCT group while the other 10 cases took place in the MDCT group, none of which was missed by either technique. There was one false positive result in the SDCT group and none in the MDCT group (96% and 100% specificity respectively, 100% sensitivity for both). Only 9% of all pulmonary emboli detected by SDCT assisted pulmonary angiography were located in subsegmental arterial branches, whereas 24% of emboli detected by MDCT angiography were subsegmental. Both SDCT and MDCT angiography are reliable tests in the detection of VTE. MDCT assisted pulmonary angiography is superior than SDCT assisted pulmonary angiography in subsegmental VTE detection.

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