Accuracy of CT angiography versus pulmonary angiography in the diagnosis of acute pulmonary embolism: Evaluation of the literature with summary ROC curve analysis

Harvey, Robert T.; Gefter, Warren B.; Hrung, Janie M.; Langlotz, Curtis P.

doi:10.1016/s1076-6332(00)80626-1

Cited by 29 publications

(14 citation statements)

References 25 publications

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“…We identifi ed 10 systematic reviews summarizing the accuracy of helical CT for the diagnosis of pulmonary embolism, [59][60][61][62][63][64][65][66][67][68] and excluded 1 study 59 for unclear study inclusion criteria (Table 4). [60][61][62][63][64][65][66][67][68] All reported either sensitivity and specifi city, or positive and negative likelihood ratios, as the primary indicators of CT performance, but they differed considerably in how the reference standard was defi ned.…”

Section: Helical Ct What Are the Test Characteristics Of Helical Ct Fmentioning

confidence: 99%

“…[60][61][62][63][64][65][66][67][68] All reported either sensitivity and specifi city, or positive and negative likelihood ratios, as the primary indicators of CT performance, but they differed considerably in how the reference standard was defi ned. Four reviews included only studies in which conventional pulmonary arteriography was the reference standard, 60,63,66,67 while the other reviews expanded the defi nition of a reference standard to include ventilation-perfusion scintigraphy 64,65,68 or overall clinical assessment. 61,62 Five reviews included only prospective studies.…”

Section: Helical Ct What Are the Test Characteristics Of Helical Ct Fmentioning

confidence: 99%

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Review of the Evidence on Diagnosis of Deep Venous Thrombosis and Pulmonary Embolism

Segal

Eng

Tamariz

et al. 2007

The Annals of Family Medicine

139

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PURPOSE This review summarizes the evidence regarding the effi cacy of techniques for diagnosis of deep venous thrombosis (DVT) and pulmonary embolism. METHODSWe searched for studies using MEDLINE, MICROMEDEX, the Cochrane Controlled Trials Register, and the Cochrane Database of Systematic Reviews through June 2006. We reviewed randomized controlled trials, systematic reviews of trials, and observational studies if no trials were available. Paired reviewers assessed the quality of each included article and abstracted the data into summary tables. Heterogeneity in study designs precluded mathematical combination of the results of the primary literature. RESULTSOur review found 22 relevant systematic reviews and 36 primary studies. The evidence strongly supports the use of clinical prediction rules, particularly the Wells model, for establishing the pretest probability of DVT or pulmonary embolism in a patient before ordering more defi nitive testing. Fifteen studies support that when a D-dimer assay is negative and a clinical prediction rule suggests a low probability of DVT or pulmonary embolism, the negative predictive value is high enough to justify foregoing imaging studies in many patients. The evidence in 5 systematic reviews regarding the use of D-dimer, in isolation, is strong and demonstrates sensitivities of the enzyme-linked immunosorbent assay (ELISA) and quantitative rapid ELISA, pooled across studies, of approximately 95%. Eight systematic reviews found that the sensitivity and specifi city of ultrasonography for diagnosis of DVT vary by vein; ultrasonography performs best for diagnosis of symptomatic, proximal vein thrombosis, with pooled sensitivities of 89% to 96%. The sensitivity of single-detector helical computed tomography for diagnosis of pulmonary embolism varied widely across studies and was below 90% in 4 of 9 studies; more studies are needed to determine the sensitivity of multidetector scanners.CONCLUSIONS While the strength of the evidence varies across questions, it is generally strong.

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Section: Helical Ct What Are the Test Characteristics Of Helical Ct Fmentioning

confidence: 99%

Section: Helical Ct What Are the Test Characteristics Of Helical Ct Fmentioning

confidence: 99%

Review of the Evidence on Diagnosis of Deep Venous Thrombosis and Pulmonary Embolism

Segal

Eng

Tamariz

et al. 2007

The Annals of Family Medicine

139

View full text Add to dashboard Cite

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“…Ein negativer Befund einer Phlebo-oder Angiographie schließt nahezu sicher das Vorliegen einer VTE aus [49]. Zusätzlich kann auch die Vena Cava zur Darstellung gebracht werden.…”

Section: Angiographie Der Pulmonalarterienunclassified

Perioperative Diagnose einer Thrombose

Lang

2009

Wien Med Wochenschr

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Venous thromboembolism (VTE) including deep vein thrombosis and pulmonary embolism is a frequent complication in postoperative setting. Despite advances in the diagnostic options conformation or exclusion of VTE remains a challenge. Preoperative assessment of thromboembolic risk factors may be helpful in estimating postoperative thromboembolic risk. Laboratory markers such as D-Dimer provide only limited information as they are modified by surgical intervention. Venous ultrasonography seems in postoperative setting a wide applicable diagnostic tool. However limited interpretation may be caused by bandage or oedema. Contrast venography und CT pulmonary angiography may be limited due to the nephrotoxic side effects of contrast agents especially in multimorbid patients. The development in magnetic resonance technology may overwhelm such problems. However magnetic implantates may also limit this modern diagnostic tool.

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“…Traditional pulmonary angiography is superior to CT or MR angiography for identification of small or subtle abnormalities such as peripheral or chronic emboli, and for detection of emboli in vessels oriented along the axial plane (which may be missed by CT angiography). 11,12 In addition, a pulmonary arterial catheter provides direct measurement of pulmonary arterial pressure.…”

Section: Pulmonary Arteriography Indicationsmentioning

confidence: 99%

Contrast Peripheral Phlebography and Pulmonary Angiography for Diagnosis of Thromboembolism

Andrews

2004

Circulation

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Abstract-At one time, direct intravascular contrast angiography was the standard method for confirmatory diagnosis of venous or pulmonary arterial thromboembolism. Although sensitive and specific, conventional catheter-based contrast imaging is invasive and associated with a risk of phlebitis and thrombosis. These procedures require specialized training and experience in catheter manipulation, as well as specialized vascular imaging equipment. In current practice, less invasive techniques have largely superceded conventional angiography because they can be performed by technologists using widely available, multifunctional apparatus under physician supervision. When results using these newer approaches are inconclusive or impractical, however, catheter-based techniques are still relied on for definitive diagnosis. The purpose of this article is to review the indications, techniques, and interpretations of contrast angiography as applied to venous thromboembolic disease.

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Accuracy of CT angiography versus pulmonary angiography in the diagnosis of acute pulmonary embolism: Evaluation of the literature with summary ROC curve analysis

Cited by 29 publications

References 25 publications

Review of the Evidence on Diagnosis of Deep Venous Thrombosis and Pulmonary Embolism

Review of the Evidence on Diagnosis of Deep Venous Thrombosis and Pulmonary Embolism

Perioperative Diagnose einer Thrombose

Contrast Peripheral Phlebography and Pulmonary Angiography for Diagnosis of Thromboembolism

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