CT pulmonary angiography (CTPA) is a contrast-enhanced CT to image pulmonary vessels and diagnose pulmonary embolism. We use CTPA as part of a protocol for imaging neutropenic hematology patients within 48 hours of fever onset. A low-dose CT is performed for screening pulmonary nodules large enough (>10 mm) to proceed to further characterization with CTPA. CTPA can show the vessel occlusion sign (VOS) and increase the visibility of the hypodense sign ( HyS) within nodular lesions. When compared to the other CT findings of invasive mould disease (IMD), the VOS is the more sensitive (97% ) and specific (97%). The contrast-aided HyS is sensitive as the halo sign but more specific ( 56% vs 98%). Overall, CTPA improves the sensitivity and specificity of CT in the detection of pulmonary IMD in neutropenic patients.
Full conference title:
- Fungal Update 2018