Evaluation of Findings In Positive D-Dimers Cases of Pulmonary Embolism Using Computed Tomography Pulmonary Angiography

Ayatullah Roohullah Khumaini; Usman  Shakil; Muhammad  Uzair; Naila  Mumtaz; Naveed  Hussain; Nosheen  Sadiq

doi:10.51253/pafmj.v75i3.11101

Authors

Ayatullah Roohullah Khumaini Department of Radiology, Combined Military Hospital Okara/National University of Medical Sciences (NUMS) Pakistan
Usman Shakil Department of Radiology, Pakistan Navy Station Shifa Karachi Pakistan
Muhammad Uzair Department of Radiology, Pakistan Navy Station Shifa Karachi Pakistan
Naila Mumtaz Department of Radiology, Pakistan Navy Station Shifa Karachi Pakistan
Naveed Hussain Department of Radiology, Pakistan Navy Station Shifa Karachi Pakistan
Nosheen Sadiq Department of Radiology, Combined Military Hospital Thal/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75i3.11101

Keywords:

Computed Tomographic Pulmonary Angiography, D-Dimers, Effusion, Pulmonary Thromboembolism

Abstract

ABSTRACT

Objectives: To evaluate findings of Computed Tomographic Pulmonary Angiography in positive D – Dimers cases of pulmonary embolism.

Study Design: Descriptive cross-sectional study.

Place and Duration of Study: Department of Radiology, PNS Shifa Hospital Karachi, Pakistan from Mar to Aug 2023.

Methodology: One hundred and thirty-nine patients fulfilling our inclusion criteria were recruited in the study. Written consent was taken from all patients. Computed Tomographic Pulmonary Angiography was done for all patients and their findings were recorded. Findings of pleural effusion, pericardial effusion, consolidation, pulmonary thromboembolism and collapse were recorded, and their frequency was noted. Impact of variables such as age and gender on outcome were checked.

Results: Mean age of the group was 48.24±10.41 years. Ninety-six (69.1%) of our patients were males while 43(30.9%) were females. Pulmonary thromboembolism was noted in 17(12.2%) patients, consolidation in 12(8.6%), pleural effusion in 10(7.2%), pericardial effusion in 4(2.9%) and collapse was noted in 1(0.7%) patient. Pulmonary thromboembolism and pleural effusions were seen in younger age group while consolidation and pericardial effusion dominated in the older age group, however the findings were not statistically significant (p>0.05).

Conclusion: Pulmonary thromboembolism was found to be the most common findings of Computed Tomographic Pulmonary Angiography followed by consolidation and pleural effusion. Age and gender did not have a significant impact on the outcome.

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References

Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galiè N, et al. 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 2014; 35: 3033–3069.

https://doi.org/10.1093/eurheartj/ehu283

Ghulam M, Ashfaq Z, Ali S, Nawaz A, Anthony N, Ghani U, et al. Association Between Venous Thromboembolism Prophylaxis and the Incidence of Thromboembolism Following Orthopedic Procedures: A Cross-Sectional Study. Cureus 2024; 16(1): e52652.

https://doi.org/10.7759/cureus.52652

Onwuzo C, Olukorode J, Sange W, Tanna SJ, Osaghae OW, Hassan A, et al. A review of the preventive strategies for venous thromboembolism in hospitalized patients. Cureus 2023; 15(11): e48421.

https://doi.org/10.7759/cureus.48421

Stadlbauer A, Verbelen T, Binzenhöfer L, Goslar T, Supady A, Spieth PM, et al. Management of high-risk acute pulmonary embolism: an emulated target trial analysis. Intensive Care Med 2025; 51(3): 490-505.

https://doi.org/10.1007/s00134-025-07805-4

Sangani S, Patil S, Darade P. Spectrum of Computed Tomography Pulmonary Angiography (CTPA) findings in clinically suspected cases of pulmonary thromboembolism. Indian J Basic Appl Med Res 2019; 8(2): 245-251. https://doi.org/10.4103/1735-1995.193509

Freund Y, Cohen-Aubart F, Bloom B. Acute pulmonary embolism: a review. Jama 2022; 328(13): 1336-1345.

https://doi.org/10.1001/jama.2022.16815

Barco S, Valerio L, Ageno W, Cohen AT, Goldhaber SZ, Hunt BJ, et al. Age-sex specific pulmonary embolism-related mortality in the USA and Canada, 2000–18: an analysis of the WHO Mortality Database and of the CDC Multiple Cause of Death database. Lancet Resp Med 2021 Jan 1; 9(1): 33-42.

https://doi.org/10.1016/S2213-2600(20)30417-3

Blondon M, Skeith L. Preventing postpartum venous thromboembolism in 2022: a narrative review. Front Cardiovasc Med 2022; 9(2): 886416. https://doi.org/10.3389/fcvm.2022.886416

Gao H, Liu H, Li Y. Value of D-dimer levels for the diagnosis of pulmonary embolism: An analysis of 32 cases with computed tomography pulmonary angiography. Exp Ther Med 2018; 16(2): 1554-1560. https://doi.org/10.3892/etm.2018.6314

Chen Z, Deblois S, Toporowicz K, Boldeanu I, Francoeur MO, Sadouni M, et al. Yield of CT pulmonary angiography in the diagnosis of acute pulmonary embolism. BMC Res Notes 2019; 12(1): 41. https://doi.org/10.1186/s13104-019-4076-8

Ferreira EV, Gazzana MB, Sarmento MB, Guazzelli PA, Hoffmeister MC, Guerra VA, et al. Alternative diagnoses based on CT angiography of the chest in patients with suspected pulmonary thromboembolism. J Bras Pneumol 2016; 42(1): 35-41.

https://doi.org/10.1590/S1806-37562016000000105

Iwuji K, Almekdash H, Nugent KM, Islam E, Hyde B, Kopel J, Opiegbe A, Appiah D. Age-adjusted D-dimer in the prediction of pulmonary embolism: systematic review and meta-analysis. J Prim Care Community Health 2021; 12(1): 21501327211054996. https://doi.org/10.1177/21501327211054996

Sasani H, Mutlu LC. Quantitative evaluation of computed tomography findings in patients with pulmonary embolism: the link between D-Dimer level and thrombus volume. Rev Assoc Med Bras 2021; 67(2): 218-223.

https://doi.org/10.1590/1806-9282.67.02.20200539ERRATUM

Troy B. Targeted D-dimer testing best for DVT diagnosis. Ann Intern Med 2013; 158: 93- 100.

https://doi.org/10.7326/0003-4819-158-2-201301150-00003

Khan F, Tritschler T, Kahn SR, Rodger MA. Venous thromboembolism. Lancet 2021; 398(10294): 64-77.

https://doi.org/10.1016/S0140-6736(20)32658-1

Nadeem I, Anwar A, Jordon L, Mahdi N, Rasool MU, Dakin J. Relationship of D-dimer and prediction of pulmonary embolism in hospitalized COVID-19 patients: a multicenter study. Future Microbiol 2021; 16(12): 863-870.

https://doi.org/10.2217/fmb-2021-0082

Deonarine P, de Wet C, McGhee A. Computed tomographic pulmonary angiography and pulmonary embolism: predictive value of a d-dimer assay. BMC Res Notes 2012; 5: 104.

https://doi.org/10.1186/1756-0500-5-104

Farogh A, Wazir NU, Mumtaz S, Salman F, Arif A, Umair A. Venous thromboembolism risk assessment in hospitalised patients in a tertiary care hospital in Pakistan. J Ayub Med Coll Abbottabad 2024; 36(2): 383-387. https://doi.org/10.55519/JAMC-02-13243

Fan BE, Lippi G, Favaloro EJ. D-dimer levels for the exclusion of pulmonary embolism: making sense of international guideline recommendations. J Thromb Haemost 2024; 22(3): 604-608.

https://doi.org/10.1016/j.jtha.2023.12.015

Zhang L, Chen Y, Liu W, Wang X, Zhang S, Zhang W, et al. Predictive value of D-dimer and analysis of risk factors in pregnant women with suspected pulmonary embolism after cesarean section. BMC Pulm Med 2021; 21(391): 1-9

https://doi.org/10.1186/s12890-021-01757-3