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Assessment of the abdominal and pelvic veins by computed tomography in patients with suspected acute pulmonary embolism and with a negative doppler ultrasonography of the lower limbs (In french)

      Purpose: To address prospectively the potential of computed tomography (CT) of the abdomen and pelvis to demonstrate deep vein thrombosis in patients suspected of acute pulmonary embolism and investigated with helical CT of the pulmonary arteries. Materials and Methods: One hundred ninety-seven patients presenting non-diagnostic scintigraphy and negative Doppler ultrasonography (US) of lower limbs and IVC were included. They had helical CT of the pulmonary arteries (5 mm collimation, 1:1 pitch, reconstruction every 2.5 mm, injection of 120 mL of contrast media at a rate of 3 mL/sec). Ninety seconds after the end of the thoracic acquisition, abdominal and pelvic CT were acquired (7 mm collimation every 12 mm). Results: Three (1.5%) of 197 patients had an unknown deep venous thrombosis of the caval system (renal vein, ovarian vein, iliac veins). A fourth patient had an unknown thrombosis of the mesenteric vein. All these patients had a pulmonary embolism (4/40). None of the 157 patients without pulmonary embolism at helical CT showed deep venous thrombosis. Conclusion: In our study, CT of the abdomen and pelvis disclosed an unknown thrombosis of a deep vein of the abdomen and pelvis that can explain the pulmonary embolism in 7.5% of patients.
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