Noninvasive diagnosis of pulmonary embolism.
نویسندگان
چکیده
BACKGROUND We designed a simple and integrated diagnostic algorithm for acute pulmonary embolism (PE). Diagnosis was based on clinical probability assessment, plasma D-dimer testing, then sequential testing to include lower limb venous compression ultrasonography, ventilation perfusion lung scan, and chest multidetector CT (MDCT) imaging. METHODS We included 321 consecutive patients presenting at Brest University Hospital in Brest, France, with clinically suspected PE and positive d-dimer or high clinical probability. Patients in whom VTE was deemed absent were not given anticoagulants and were followed up for 3 months. RESULTS Detection of DVT by ultrasonography established the diagnosis of PE in 43 (13%). Lung scan associated with clinical probability was diagnostic in 243 (76%) of the remaining patients. MDCT scan was required in only 35 (11%) of the patients. The 3-month thromboembolic risk in patients not given anticoagulants, based on the results of the diagnostic protocol, was 0.53% (95% CI, 0.09-2.94). CONCLUSIONS A diagnostic strategy combining clinical assessment, d-dimer, ultrasonography, and lung scan gave a noninvasive diagnosis in the majority of outpatients with suspected PE and appeared to be safe.
منابع مشابه
A Report on Emergent Pulmonary Embolectomy
Introduction: Pulmonary embolism is one of the leading causes of mortality in patients.The mortality rate of this disease can be significantly reduced with appropriate treatment. Surgical intervention can be highly effective for the treatment of acute massive pulmonary embolism. This article presents a report on the experience of acute pulmonary embolectomy. Materials and Methods: Demographic d...
متن کاملDiagnosis of pulmonary embolism with magnetic resonance angiography.
BACKGROUND Diagnosing pulmonary embolism may be difficult, because there is no reliable noninvasive imaging method. We compared a new noninvasive method, gadolinium-enhanced pulmonary magnetic resonance angiography, with standard pulmonary angiography for diagnosing pulmonary embolism. METHODS A total of 30 consecutive patients with suspected pulmonary embolism underwent both standard pulmona...
متن کاملEvaluation of CT angiography findings in the patients with clinical diagnosis of pulmonary thromboembolism
Background and Aim: Pulmonary thromboembolism is an important clinical problem in the patients after major surgeries and is often difficult to diagnose because of nonspecific clinical symptoms. Diagnosis of pulmonary embolism is based on medical imaging methods. The aim of this study was to evaluate the results of CT pulmonary angiographies of the patients with primary clinical diagnosis of pul...
متن کاملPulmonary Embolism as a Rare Complication of Liver Hydatid Cyst: Report of Two Cases
Hydatid cyst is a helminth infection. The rupture of a hepatic hydatid cyst in inferior vena cava is a rare and lethal complication. Pulmonary embolism is the commonest manifestation. The diagnosis of hydatid cyst is made by histopathological or serological examination, and imaging may suggest the probability of hydatid cyst. Surgical treatment should be performed with caution and always under ...
متن کاملDetermination of Diagnostic Value of Albumin, Anti Thrombin Ш, and Fibrinogen Factors in the Diagnosis of Pulmonary Embolism Compared to Lung Perfusion Scan in Patients with Nephrotic Syndrome
Bachground: The aim of this study was to determine of diagnostic value of albumin, anti-thrombin Ш, and fibrinogen factors in the diagnosis of pulmonary embolism compared to lung perfusion scan in patients with nephrotic syndrome referred to Hazrat Ali Asghar hospital of Tehran city (Iran) in 2018-2019. Methods: This study was cross sectional study that was carried out on 30 patients with nep...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- International journal of cardiology
دوره 65 Suppl 1 شماره
صفحات -
تاریخ انتشار 1998