[CT x-ray evaluation of abdominal and pelvic veins in patients suspected of acute pulmonary embolism with negative Doppler sonography].
To address prospectively the potential of CT of the abdomen and pelvis to demonstrate deep vein thrombosis in patients suspected of acute pulmonary embolism and investigated with helical CT of the pulmonary arteries. 197 patients presenting non-diagnostic scintigraphy and negative Doppler US of lower limbs and IVC were included. They had helical CT of the pulmonary arteries (5mm collimation, 1:1 pitch, reconstruction every 2.5 mm, injection of 120 mL of contrast media at a rate of 3 mL/sec). Ninety seconds after the end of the thoracic acquisition, abdominal and pelvic CT were acquired (7 mm collimation every 12 mm). 3 (1.5%) of 197 patients had an unknown thrombosis of the caval system (renal vein, ovarian vein, lilac veins). A fourth patient had an unknown thrombosis of the mesenteric vein. All these patients had a pulmonary embolism (4/40). None of the 157 patients without pulmonary embolism at helical CT showed deep venous thrombosis. In our study, CT of the abdomen and pelvis disclosed an unknown thrombosis of a deep vein of the abdomen and pelvis that can explain the pulmonary embolism in 7.5% of patients.