Audit on the use of CTPA in patients with clinically suspected pulmonary embolism


  • Faryal Riaz PGR Diagnostic Radiology PIC, Lahore
  • Amna Malik Consultant Radiologist Punjab Instituite of Cardiology Lahore


Objectives: To evaluate PE diagnostic work-up prior to requesting CTPA and to investigate

whether CTPA is an over-ordered test.

Setting: The study was conducted in the department of Diagnostic Radiology in collaboration

with Department of Cardiology, PIC, Lahore.

Material and Method:  All patients who had clinical suspicion of pulmonary embolism and

Age(20-60 years) were included in the study and exclusion criteria was CKD, contrast allergy

and patients with chronic lung disease.  Study period: 1/3/2020 to 30/11/2020 (9 months

period). Study Design: Retrospective cohort study. Sampling technique: Random, convenient

and non purposive sampling. Data interpretation and analysis: The results of Patients

demographics, pre CT work up (Well’s score, Chest X-Ray, ECG, D-Dimers, Doppler USG for DVT

and CTPA findings) were calculated, entered in SPSS version 21 and simple % was calculated.

This data was compared with studies world wide.


In our study 75 patients were followed up for pulmonary embolism, 39 (52%) were males and

36 (48%) were females. Mean age was 44 years, 5 (7%) had malignancy, 12 (16%) had previous

surgery or trauma, 30 (40%) had previous DVT. Wells score was only done in (7%) of the

patients, ECG (15%), CXR (70%), D-Dimer (7%). Only (35%) of the patients in the cohort were

diagnosed to have pulmonary embolism on CTPA. Only (4%) of patients diagnosed PE on CTPA

had Wells score calculated before CTPA.

Conclusion: The audit suggests that CTPA was an over-ordered test in our hospital and inadequate initial clinical assessment is leading to improper use of CTPA.

 Key words: CTPA, Pulmonary embolism, Deep venous thrombosis, Well’s score