Angioscanner thoracique à propos de 450 suspicions d’embolie pulmonaire à Cotonou

djiva

doi:10.55715/jaim.v13i1.142

Authors

djiva

DOI:

https://doi.org/10.55715/jaim.v13i1.142

Keywords:

CT angiography, pulmonary embolism, alternative diagnosis, prognosis, Cotonou

Abstract

Objective: to describe the results of CT angiography in patients suspected of pulmonary embolism in Cotonou.

Materials and Methods: A retrospective cross-sectional descriptive and analytical study was conducted over a period of 42 months in two medical imaging departments in Cotonou. Included were all patients of both sexes and of any age who had undergone a CT angiography for suspected pulmonary embolism (PE) and whose reports were found in the archives of the two facilities. Descriptive data on the socio-demographic characteristics of patients, prescribers and CT angiography lesions were described using frequency calculations. The association between the occurrence of pulmonary embolism and alternative diagnoses on the one hand and socio-demographic factors on the other hand was investigated. The Pearson Chi2 test was used to compare the variables. At alpha = 5%, the association between the angioscanner result and the explanatory variables was considered statistically significant if p < 0.05. The strength of the association was estimated using the prevalence ratio (PR).

Results: Of the 450 suspect patients included, 26.44% had pulmonary embolism, 32.44% had an alternative diagnosis and 41.11% had a strictly normal CT angiography. Of the 119 PE-positive CT angiography, 21 (17.64%) had a DV/VG index >1. A proximal thrombus was 4.69 more likely to provide cardiac resonance than a lobar thrombus, IC95%=1.62-13.56, p=0.0004. Age greater than 60 years was the main factor associated with the occurrence of pulmonary embolism and the presence of an alternative diagnosis. The most common alternative diagnoses were acute pulmonary edema due to congestive heart failure, infectious pneumonitis and tumor pathology.

Conclusion: PE is common in Cotonou. CT angiography confirmed or excluded the diagnosis of PE and/or allowed for alternative diagnoses to be made.

Downloads

Download data is not yet available.

References

1. Jolibert M, Vidal V, Cohen F, Bartoli J-M, Moulin G, Jacquier A, et al. Amélioration de l’angioscanner thoracique dans le cadre d’une EPP. Journal de Radiologie. janv 2011;92(1):20‑4
2. Dogan H, de Roos A, Geleijins J, Huisman M, Kroft L. The role of computed tomography in the diagnosis of acute and chronic pulmonary embolism. Diagn Interv Radiol. 3 juill 2015;21(4):307‑16
3. Clément H, Feydy A, André S, Trimech N-M, Drappé J-L, Pourriat J-L, et al. Quels sont les diagnostics retenus après angioscanner thoracique chez les patients des urgences suspects d’embolie pulmonaire ? Ann Fr Med Urgence. janv 2011;1(1):21‑5
4. Pessinaba S, Molba YD, Baragou S, Pio M, Afassinou Y, Kpélafia M, et al. L’embolie pulmonaire au centre hospitalier universitaire Campus de Lomé (Togo): étude rétrospective à propos de 51 cas. Pan Afr Med J [Internet]. 2017 [cité 1 mars 2021];27. Disponible sur: http://www.panafrican-med-journal.com/content/article/27/129/full/
5. Gbadamassi AG, Adjoh KS, Aziagbe AK, Ounteni AM, Pwendéou E, Adambounou AS. Aspects épidémiologiques et évolutifs de l’embolie pulmonaire dans le service de pneumo-phtisiologie du Centre Hospitalier Universtaire Sylvanus Olympio. J Func Vent Pulm 2018 ;26(9) :1-48
6. Miniati M, Cenci C, Monti S, Poli D. Clinical Presentation of Acute Pulmonary Embolism: Survey of 800 Cases. Er F, éditeur. PLoS ONE. 27 févr 2012;7(2):e3089
7. Galanaud J-P, Blanchet-Deverly A, Pernod G, Quéré I. Prise en charge de l’embolie pulmonaire en 2015. Journal des Maladies Vasculaires. févr 2016;41(1):51‑62
8. Righini M, Robert-Ebadi H, Le Gal G. Diagnostic de l’embolie pulmonaire. La Revue de Médecine Interne. juill 2019;40(7):440‑4
9. Ancion A, Melissopoulou M., Lancellotti P. Recommandations européennes concernant le diagnostic de l’embolie pulmonaire Rev Med Liège 2015; 70 (1) : 17-21
10. Tresoldi S, Kim YH, Baker SP, Kandarpa K. MDCT of 220 consecutive patients with suspected acute pulmonary embolism: incidence of pulmonary embolism and of other acute or non-acute thoracic findings. Radiol med. avr 2008;113(3):373‑84
11. Vongchaiudomchoke T, Boonyasirinant T. Positive Pulmonary Computed Tomography Angiography in Patients with Suspected Acute Pulmonary Embolism: Clinical Prediction Rules, Thromboembolic Risk Factors, and Implications for Appropriate Use. J Med Assoc Thai. janv 2016;99(1):25‑33
12. Tambe J, Moifo B, Fongang E, Guegang E, Juimo AG. Acute pulmonary embolism in the era of multi-detector CT: a reality in sub-Saharan Africa. BMC Med Imaging. déc 2012;12(1):31
13. Traoré M, Konaté M, Sidibé FM, Koné A C, NDiaye M, Diawara Y, et al., Apport de l’angioscanner thoracique dans le diagnostic de l’embolie pulmonaire dans le service de radiologie et de médecine nucléaire du chu du point «G». Mali Médical 2019 34 (1). :7‑12.
14. Schellhaaß A, Walther A, Konstantinides S, Böttiger BW. The Diagnosis and Treatment of Acute Pulmonary Embolism. Deutsches Aerzteblatt Online [Internet].
30 août 2010; Disponible sur: https://www.aerzteblatt.de/10.3238/arztebl.2010.0589
15. Ramlakhan R, Andronikou S, Rajkumar A. The prevalence and radiological findings of pulmonary embolism in HIV-positive patients referred for computed tomography pulmonary angiography in the Western Cape of South Africa. CVJA. 5 sept 2017;28(4):221‑8.
16. Jiménez D, Lobo JL, Monreal M, Otero R, Yusen RD. Prognostic significance of multidetector computed tomography in normotensive patients with pulmonary embolism: rationale, methodology and reproducibility for the PROTECT study. J Thromb Thrombolysis. août 2012;34(2):187‑92
17. Ghaye B, Ghuysen A, Bruyere P-J, D’Orio V, Dondelinger RF. Can CT Pulmonary Angiography Allow Assessment of Severity and Prognosis in Patients Presenting with Pulmonary Embolism? What the Radiologist Needs to Know. RadioGraphics. janv 2006;26(1):23‑39
18. Bazeed MF, Saad A, Sultan A, Ghanem MA, Khalil DM. Prediction of pulmonary embolism outcome and severity by computed tomography. Acta Radiol. avr 2010;51(3):271‑6.
19. Becattini C, Agnelli G, Vedovati MC, Pruszczyk P, Casazza F, Grifoni S, et al. Multidetector computed tomography for acute pulmonary embolism: diagnosis and risk stratification in a single test. European Heart Journal. 1 juill 2011;32(13):1657‑63
20. Akhoundi N, Langroudi T, Rajebi H, Haghi S, Paraham M, Karami S, et al. Computed tomography pulmonary angiography for acute pulmonary embolism: prediction of adverse outcomes and 90-day mortality in a single test. pjr. 2019; 84:436‑46.
21. Esiéné A, Tochie JN, Metogo JAM, Etoundi PO, Minkande JZ. A comparative analysis of the diagnostic performances of four clinical probability models for acute pulmonary embolism in a sub-Saharan African population: a cross-sectional study. BMC Pulm Med. déc 2019;19(1):263.