Evaluation of Pulmonary Embolisms Using Coronal Reformations on 64-Row Multidetector-Row Computed Tomography

Objective: To evaluate coronal reformations of the chest on 64-row multidetector-row computed tomography (MDCT) for detection of pulmonary embolisms compared with axial images. Methods: Thirty-eight consecutive patients who underwent pulmonary computed tomography angiography (CTA) on 64-row MDCT for a suspected pulmonary embolism were retrospectively studied. Contiguous 2-mm axial and coronal images were reviewed independently. A pulmonary embolism was assessed in the main, lobar, or segmental pulmonary arteries and was scored using a 5-point scale. Results: A pulmonary embolism was demonstrated in 10% (4 of 38) of axial images and 16% (6 of 38) of coronal images. Interpretation was concordant in 95% to 100% of cases for a main or lobar pulmonary embolism and in 80% to 82% of cases for a segmental pulmonary embolism. Agreement of scores was almost perfect for a amain or lobar pulmonary embolism (mean weighted κ value = 0.969) and moderate to good for a segmental pulmonary embolism (mean weighted κ value = 0.560). Conclusion: Coronal reformations of the chest on 64-row MDCT were as informative as axial images for the detection of main, lobar, and segmental pulmonary embolisms.