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Purpose: To evaluate electron beam tomography in the detection of acute pulmonary embolism using a new acquisition protocol., Materials and Methods: 65 patients underwent electron beam tomography (EBT) and v./p. scintigraphy. According to the inclusion criteria 46 patients participated in the study. Contrast enhancement and detectability of pulmonary arteries were scored on a 4 step scale for image quality. The results of prospective detection of pulmonary embolism were compared for both modalities (blinded reading). "Embolism", "questionable embolism" and "no embolism" were used as categories., Results: 22/46 patients (48%) showed acute pulmonary embolism. EBT and scintigraphy were discordant in 24% of patients. In EBT 1 false positive and 1 false negative case occurred, scintigraphy demonstrated 2 false negative and 3 false positive cases. 6/9 patients with questionable findings in scintigraphy were correctly classified by EBT to a category "embolism" or "no embolism" as "suspected embolism", EBT displayed a sensitivity of 96.3% and a specificity of 94.7%. Scintigraphy evidenced a sensitivity of 93.7% and a specificity of 84.4%., Conclusions: EBT shows better results than scintigraphy for the detection of acute pulmonary emboli. The evaluated new acquisition protocol for EBT seems to be well suited. High vessel contrast and thin slices allow a reliable detection of segmental and subsegmental pulmonary arteries.

The so-called amyopathic dermatomyositis is a rare variant of dermatomyositis which has attracted increasing interest during the last years. One finds the classical signs of dermatomyositis such as periorbital edema and erythema, erythematous macular and papular lesions localized at bony prominences (so-called Gottron's papules), generalized pruritus, photosensitivity, and a cutaneous histopathologic picture compatible with skin lesions of dermatomyositis. Crucial for the diagnosis is the exclusion of myositis by clinical examination, EMG and histology. Furthermore, longterm supervision of patients is advisable in order not to miss the appearance of early signs of myositis. The longest reported follow-up of amyopathic dermatomyositis patient is 4 years; however, it cannot be excluded that these cases will eventually culminate in classical dermatomyositis. In this paper we describe two cases and discuss the differential diagnosis and therapy; also, the term "Premyopathic dermatomyositis" is proposed, to indicate that the full picture is to be expected in most cases.