Asian Journal of Research in Medicine and Medical Science

Objective: To assess the prevalence of clinically significant and insignificant incidental findings that had therapeutic consequences at the department of radiology in tertiary care academic hospital.

Study Design and Methodology: This is a retrospective study. All patients undergoing CTPA at Liaquat National Hospital Karachi during a period of two years from January 2019 to December 2020, were included in the study. Radiology data was extracted from our institution’s PACS software (OSIRIX) and was reported by an experienced radiologist in department of radiology at Liaquat National hospital Karachi. We measured the prevalence of non PE significant and insignificant incidental findings and placed them into the following 3 categories. 1) Findings that explained the patient’s acute symptoms, (2) incidental findings that required radiologic follow-up, and (3) other findings that did not require follow-up.

Results: There were 54% patients with age ≤35 years and 46% with age >35 years. Their gender distribution was noted as 49.8% males and 50.2% females. The incidental findings were noted as infiltrates (37%), pleural effusion (43.7%), pneumothorax (2.6%), pneumomediastinum (0.3%), pericardial effusion (4.2%), lymph nodes (53.7%), malignancy (8.7%), emphysema (11.3%),  intra-abdominal pathology (45.3%), P.E positive (14.5%), consolidation (22.8%), bronchiectasis(7.1%), pulmonary edema (1.9%) and  musculoskeletal injury (4.2%).

Conclusion: In patients with suspected pulmonary embolism, a wide range of incidental findings and simultaneous pathologies can be seen in CTPA. Therefore, the use of clinical algorithms is necessary for more definite approach to differential diagnoses of pulmonary embolism.