What is the role of helical (spiral) CT scanning in the workup of ...

Helical (spiral) computed tomography (CT) allows for the imaging of pulmonary vessels by way of intravenous (IV) contrast material as the patient moves ... ForYou News&Perspective Drugs&Diseases CME&Education Academy Video DecisionPoint  Specialty: Multispecialty Allergy&Immunology Anesthesiology BusinessofMedicine Cardiology CriticalCare Dermatology Diabetes&Endocrinology EmergencyMedicine FamilyMedicine Gastroenterology GeneralSurgery Hematology-Oncology HIV/AIDS HospitalMedicine InfectiousDiseases InternalMedicine Multispecialty Nephrology Neurology Ob/Gyn&Women'sHealth Oncology Ophthalmology Orthopedics Pathology&LabMedicine Pediatrics PlasticSurgery Psychiatry PublicHealth PulmonaryMedicine Radiology Rheumatology Transplantation Urology MedicalStudents Nurses Pharmacists Residents TodayonMedscape Edition: ENGLISH DEUTSCH ESPAÑOL FRANÇAIS PORTUGUÊS UK LogIn SignUpIt'sFree! Edition: ENGLISH DEUTSCH ESPAÑOL FRANÇAIS PORTUGUÊS UK Register LogIn NoResults NoResults Saturday,January1,2022 ForYou News&Perspective Drugs&Diseases CME&Education Academy Video DecisionPoint close PleaseconfirmthatyouwouldliketologoutofMedscape. Ifyoulogout,youwillberequiredtoenteryourusernameandpasswordthenexttimeyouvisit. Logout Cancel https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly93d3cubWVkc2NhcGUuY29tL2Fuc3dlcnMvMTI2NzcxNC0xMjQwNTcvd2hhdC1pcy10aGUtcm9sZS1vZi1oZWxpY2FsLXNwaXJhbC1jdC1zY2FubmluZy1pbi10aGUtd29ya3VwLW9mLXZlbm91cy10aHJvbWJvZW1ib2xpc20tdnRl processing.... Drugs&Diseases > OrthopedicSurgery > VenousThromboembolism(VTE)Q&A Whatistheroleofhelical(spiral)CTscanningintheworkupofvenousthromboembolism(VTE)? Updated:Nov05,2020 Author:VeraADePalo,MD,MBA,FCCP;ChiefEditor:VinodKPanchbhavi,MD,FACS,FAOA,FABOS,FAAOS more... References Share Email Print Feedback Close Facebook Twitter LinkedIn WhatsApp Answer Helical(spiral)computedtomography(CT)allowsfortheimagingofpulmonaryvesselsbywayofintravenous(IV)contrastmaterialasthepatientmovesthroughagantryataconstantrateandtheradiographysourcerotates.PEisdiagnosedbyidentifyingfillingdefects,whichareeithercentraloradherenttothewall(seetheimagebelow). HelicalCTscanofthepulmonaryarteries.Afillingdefectintherightpulmonaryarteryispresent,consistentwithapulmonaryembolism. ViewMediaGallery TheadvantageofhelicalCTisthatitisminimallyinvasiveandallowsconcurrentvisualizationoftheparenchyma,pleura,andmediastinum.Whenlookingatthemain,lobar,andsegmentalveins,helicalCThasasensitivityofabout93%.Itspositivepredictivevalueisapproximately95%. ThelimitationsofhelicalCTincludetheneedforcontrastandtherequirementforahigherdoseofradiationthanisusedwithsomeotherdiagnosticmodalities.Obliquelyorhorizontallyorientedvessels(eg,thoseofthesegmentalbranchesoftherightmiddlelobeandlingula)arepoorlyvisualized.Thescanistechnicallyinadequateorinconclusiveinapproximately1-10%ofcases. ReadMore Didthisansweryourquestion? Yes No Additionalfeedback?(Optional) Submit Thankyouforyourfeedback! RelatedQuestions:   References MerliGJ.Preventionofthrombosiswithwarfarin,aspirin,andmechanicalmethods.ClinCornerstone.2005.7(4):49-56.[Medline]. AgnelliG,SonagliaF,BecattiniC.Directthrombininhibitorsforthepreventionofvenousthromboembolismaftermajororthopaedicsurgery.CurrPharmDes.2005.11(30):3885-91.[Medline]. AgudeloJF,MorganSJ,SmithWR.Venousthromboembolisminorthopedictraumapatients.Orthopedics.2005Oct.28(10):1164-71;quiz1172-3.[Medline]. 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LachiewiczPF.Preventionofsymptomaticpulmonaryembolisminpatientsundergoingtotalhipandkneearthroplasty:clinicalguidelineoftheAmericanAcademyofOrthopaedicSurgeons.InstrCourseLect.2009.58:795-804.[Medline]. JohansonNA,LachiewiczPF,LiebermanJR,LotkePA,ParviziJ,PellegriniV,etal.Preventionofsymptomaticpulmonaryembolisminpatientsundergoingtotalhiporkneearthroplasty.JAmAcadOrthopSurg.2009Mar.17(3):183-96.[Medline]. MediaGallery Pulmonaryembolismwithinthepulmonaryartery. Ventilation-perfusionscan.Leftimage:Posteriorviewofnormalfindingsonventilationscan.Rightimage:Posteriorviewofaperfusionscanthatrevealsaperfusiondefectintheleftupperquadrant.Thedefectinthemiddleoftheimageisduetothepositionoftheheart. HelicalCTscanofthepulmonaryarteries.Afillingdefectintherightpulmonaryarteryispresent,consistentwithapulmonaryembolism. of 3 Tables BacktoList ContributorInformationandDisclosures Author VeraADePalo,MD,MBA,FCCP MedicalDirector/Consultant,RespiratoryTherapyProgram,NewEnglandInstituteofTechnology;ConsultingPhysician,TruCare VeraADePalo,MD,MBA,FCCPisamemberofthefollowingmedicalsocieties:AmericanCollegeofChestPhysicians,MassachusettsMedicalSociety,RhodeIslandThoracicSocietyDisclosure:Nothingtodisclose. Coauthor(s) AbdallahEKharnaf,MD ResidentPhysician,DepartmentofMedicine,MemorialHospitalofRhodeIsland,TheWarrenAlpertMedicalSchoolofBrownUniversity AbdallahEKharnaf,MDisamemberofthefollowingmedicalsocieties:AmericanCollegeofPhysiciansDisclosure:Nothingtodisclose. ChiefEditor VinodKPanchbhavi,MD,FACS,FAOA,FABOS,FAAOS ProfessorofOrthopedicSurgery,Chief,DivisionofFootandAnkleSurgery,Director,FootandAnkleFellowshipProgram,DepartmentofOrthopedicSurgery,UniversityofTexasMedicalBranchSchoolofMedicine VinodKPanchbhavi,MD,FACS,FAOA,FABOS,FAAOSisamemberofthefollowingmedicalsocieties:AmericanAcademyofOrthopaedicSurgeons,AmericanCollegeofSurgeons,AmericanOrthopaedicAssociation,AmericanOrthopaedicFootandAnkleSociety,OrthopaedicTraumaAssociation,TexasOrthopaedicAssociationDisclosure:Serve(d)asaspeakeroramemberofaspeakersbureaufor:Styker. Acknowledgements MichaelJBelanger,MDClinicalInstructor,DepartmentofOrthopedics,HarvardMedicalSchool Disclosure:Nothingtodisclose. JeganKrishnan,MBBS,FRACS,PhDProfessor,Chair,DepartmentofOrthopedicSurgery,FlindersUniversityofSouthAustralia;SeniorClinicalDirectorofOrthopedicSurgery,RepatriationGeneralHospital;PrivatePractice,OrthopaedicsSA,FlindersPrivateHospital JeganKrishnan,MBBS,FRACS,PhD,isamemberofthefollowingmedicalsocieties:AustralianMedicalAssociation,AustralianOrthopaedicAssociation,andRoyalAustralasianCollegeofSurgeons Disclosure:Nothingtodisclose. FranciscoTalavera,PharmD,PhDAdjunctAssistantProfessor,UniversityofNebraskaMedicalCenterCollegeofPharmacy;Editor-in-Chief,MedscapeDrugReference Disclosure:MedscapeSalaryEmployment JeromeDWiedel,MDChair,Professor,DepartmentofOrthopedics,UniversityofColoradoHealthSciencesCenter Disclosure:Nothingtodisclose. 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