To improve the pulmonary embolism detection rate of the lung cancer patients through analyzing the characteristics of pulmonary computed tomography angiography (CTA) of the patients with lung cancer complicated with pulmonary embolism (PE).

The clinical data of 90 patients with PE primarily diagnosed by pulmonary CTA were retrospectively reviewed. And 40 patients complicated with lung cancer were taken as the case group and 50 patients complicated with no lung cancer were taken as the control group. The imaging features of pulmonary CTA including thrombus location, pulmonary arterial diameter, severity of pulmonary embolism, the combination of intrapulmonary exudation and pleural effusion or not, and other PE direct/indirect signs were analyzed and compared between the two groups.

Central type of PEs occurred in 22 patients (55%) in the case group and 15 patients (30%) in the control group (P<0.05). And 14 patients (35%) were complicated with lung exudative lesions in the case group and 29 patients (58%) in the control group (P<0.05). Moreover, 19 patients (47.5%) had pleural effusion in the case group and 13 patients (26%) in the control group (P<0.05). All the above comparisons showed statistical significant differences. Whereas, there was no significant difference in the widened pulmonary arterial diameter, with 11 patients (27.5%) in the case group and 9 patients (18%) in the control group (P>0.05). As for the severity of PE, we firstly performed the comparison of non-massive and massive PEs together with non-massive and submassive PEs within groups, meanwhile, the results showed that non-massive PEs both accounted for the highest proportion in the two groups (P<0.05). Secondly, the inter-group comparisons of massive and massive PEs (P=0.083) together with submassive and submassive PEs (P=0.090) also were carried out, but the results showed no remarkable differences. However, the patients in the case group had a higher risk to develop non-massive PE, in comparison with the patients in the control group (P=0.040). The risk factor analysis demonstrated that 9 patients (22.5%) in the case group suffered from deep venous thrombosis (DVT) in the lower extremity, in contrast to the 13 individuals (26.0%) in the control group (P>0.05).

Awareness of the special imaging features of PE combined with lung cancer may contribute to improve the prognosis of such patients.