Noninvasive diagnosis of pulmonary embolism.

نویسندگان

  • Pierre-Yves Salaun
  • Francis Couturaud
  • Alexandra Le Duc-Pennec
  • Karine Lacut
  • Pierre-Yves Le Roux
  • Philippe Guillo
  • Pierre-Yves Pennec
  • Jean-Christophe Cornily
  • Christophe Leroyer
  • Grégoire Le Gal
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.

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عنوان ژورنال:
  • International journal of cardiology

دوره 65 Suppl 1  شماره 

صفحات  -

تاریخ انتشار 1998