Diagnostic Utility of Ultrasonography of Leg Veins in Patients Suspected of Having Pulmonary Embolism

Abstract

The diagnostic value of compression ultrasonography for the detection of deep venous thrombosis in patients suspected of having pulmonary embolism is limited; the gain in diagnostic efficiency obtained through the use of ultrasonography may be offset by a loss in diagnostic accuracy.

Medical management of venous thromboembolic disease

“…Since a DVT is present in 70% of patients by classic venography with confirmed PE, the finding of a DVT in a patient with pulmonary symptomatology of PE confirms a PE diagnosis (20).…”

Pulmonary embolism: an unsuspected killer

“…If ultrasound is positive for DVT, PE is implied, and the patient should be treated accordingly with no further testing necessary. In pregnant patients being evaluated for PE without specific symptoms of DVT, however, ultrasound is rarely positive [66][67][68].…”

“…Subsegmental emboli are not visualized well on angiogram either [24,101]. Newer thin-collimation multislice CT scanners have increased speed and allow improved visualization with less motion artifact [68]. The clinical significance of isolated subsegmental emboli is uncertain and has been questioned [102].…”

Diagnosis of pulmonary embolism in the coronary care unit

“…Venous ultrasound detected deep venous thrombosis in 15% of patients with suspected PE 46 and in 29% with proven PE 46 thereby allowing treatment with no further obligatory testing.…”