Last month, I mentioned that we hardly see incidental findings on cardiac CT, even though we look for them, and put up two cases, one of multiple nodules and one a left upper lobe nodule.. Last week, on the same day we had two cases, one of pulmonary thrombo-embolism and one of extensive lymphadenopathy and bone lesions.
This 74-years old lady came with chest pain. She was sent to rule out coronary artery disease. Her heart rate was 82 even after adequate beta-blocking and we went ahead with the study since we have been getting consistent, good results in the mid-80s.
Her coronary arteries were normal (Fig. 1). Both pulmonary arteries however showed filling defects, consistent with significant pulmonary thrombo-embolism (Figs. 2, 3). However, since in our protocol, the contrast in the pulmonary arteries is supposed to be washed out with saline, the depiction of the filling defects is sub-optimal for a 64-slice CT.
I still believe that to do a triple rule out, the way it is being advocated will mean doing sub-optimal coronary studies, which defeats the very purpose.
The articles fwd are very interesting and informative.
Thankyou,
Yours Sincerely,
Rajat
Posted by: Dr Rajat Sharma | August 28, 2005 at 10:36 PM