Detection of Central Pulmonary Embolism on Non-Contrast CT

Abstract Background Pulmonary embolism (PE) is a common condition with considerable morbidity and mortality; it is more often diagnosed post-mortem by pathologists than in vivo by clinicians. Prompt and accurate diagnosis is difficult because PE may be clinically silent, the symptoms are vague and nonspecific, and in addition there is no definitive, non-invasive diagnostic test to establish its diagnosis. Objectives The aim of this study is to discuss the reliability and clinical effectiveness of the incidental detection of a PE on non-contrast CT which could be advantageous in the emergent context and also in patients with pre-existing renal disease or known allergies to contrast agents in a situation without viable alternative. Patients and Methods Results In our study CTA was used as the method of choice in detection of central pulmonary embolism in highly suspected pulmonary embolism in twenty patients and we compared it with pre contrast scan to identify non contrast CT reliability in detection of central pulmonary embolism. Our study showed that non contrast CT chest have a good role in detection of central pulmonary embolism as hyper dense lumen sign. Conclusion Unenhanced MDCT is an alternative approach for the diagnosis of acute central PE when CTPA is inaccessible or contraindicated. In our study Non-contrast chest CT scans have good role in evaluation of PE through detection the hyper dense lumen sign that is a good indicator of acute pulmonary thromboembolism particularly in cases involving the central pulmonary arteries.