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Purpose: The use of advanced medical imaging in the emergency department (ED) has increased substantially. With this rapid increase the possibility of both the low diagnostic efficiency of these imaging methods as well as the possible damages that may occur due to these methods. In this regard, the use of pulmonary computed tomography angiography (pulmonary CTA), which is one of the advanced imaging methods in patients with suspected pulmonary embolism (PE), stands out. Acute PE is an important cause of morbidity and mortality worldwide. In this study, we aimed to investigate the diagnostic efficiency of pulmonary CTA in patients who applied to Çanakkale Onsekiz Mart University Hospital Emergency Service and requested pulmonary CTA with a pre-diagnosis of PE. Material -method: After ethics committee approval this study was carried out by retrospectively examining the radiological images and medical records of patients who were admitted to Çanakkale Onsekiz Mart University Emergency Department between January 2016 and June 2018, and requested pulmonary CTA examination with a pre-diagnosis of PE, The clinical information of the patients included in the study were examined by two emergency room doctors and radiological images by two radiologist blindly. Study data were analyzed using SPSS 19 package program. Mann Whitney U test was used for comparison of numerical variables and Chi-Square test was used for comparison of categorical variables. İn the interpretation os statistical data, p< 0.05 was considered significant. Results: İn this study, a total of 233 patients who were admitted to the emergency department between January 01 2016- June 01 2018 and had pulmonary CTA with a pre-diagnosis of PE were identified. Eleven of the patients were excluded from the study because of insufficient pulmonary CTA image quality due to artifacts. The data of the remaining 222 patients were analyzed. While pulmonary embolisim was found in 19 (8.6%) patients (Group-1), pulmonary embolisim was not found in 203 (91.4%) patients (Group-2). No pathology was observed in two (0.9%) of the patients without embolism and reported as normal. İn both groups, the patients most frequently applied to the emergency department with complaints of shortness of breath and secondly, chest pain. Although the D-Dimer values of the patients were above normal in all patients found higher in group-1 than group-2 (6.42 ± 8.02 µg/L in Group-1 2.38 ± 1.99 µg/L in Group-2 N:< 0.5 µg/L). However, the finding was not statistically significant (p> 0.05 Table-2). Platelet count and lactate value was higher in patients with PE (Group-1) compared to patients without PE (Group-2) (341.71 ± 146.23, 263.72 ± 107.28 cells / ml 5.93 ± 6.97, 2.22 ± 2.07 mg / dL, respectively) However, no statistically significant difference was found between the low, medium or high level platelet and low or high level lactate groups and the groups with PE (Group-1) and those without PE (Group-2). (p> 0.05 Table-3-4). Chlorine value was found to be lower in patients with PE (Group-1) compared to patients without PE (Group-2) (94.92 ± 5.38, 99.41 ± 5.15 mmol / L, respectively). A statistically significant difference was found between low, medium or high chlorine groups and PE (Group-1) and PE (Group-2) groups (p <0.05). In addition, patients with low chlorine PE (Group-1) were observed in more patients than the group without PE (Group-2). (Table-5) Some data on clinical decision rules (CDS) parameters could not be accessed from the patients' files on the hospital information system. Conclusions: As a result, we found the diagnostic efficiency of pulmonary CTA required with PE pre-diagnosis to be low (8.6%), consistent with the literature. However, we think that further studies are needed to increase the accuracy and performance of the examination. Key Words: Emergency Department, Pulmonary embolisms, Computed tomographic pulmonary angiograpy

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