Predictive value of using Thoracic Ultrasound in diagnosis of Pulmonary Embolism

Abstract

Background: Pulmonary Embolism (PE) is a major cause of morbidity and death in patients worldwide. PE is a common and potentially fatal disease that is caused by a perfusion defect due to an embolus blocking blood flow in the lungs. Aim: Aim of this study is to assess predictive value of chest ultrasound in diagnosis of pulmonary embolism using computed tomography pulmonary angiography (CTPA) as a gold standard. Material and Method: In this study seventy three patients of suspected pulmonary embolism were attend to the emergence unit of chest, cardiology departments at Minia Cardiothoracic University Hospital in the period between June 2018 to October 2019. The patients were included according to inclusion criteria listed later. The patients were evaluated clinically and assess risk factors and probability scores (modified wells criteria). Then, Thoracic Ultrasonography (TUS) was done. Multi-slice computed tomography (MSCT) was the reference gold standard method in this study. MSCT scans were interpreted by a radiologist who was unaware of the TUS results. Predictive value of chest ultrasound in diagnosis of pulmonary embolism was evaluated by measuring sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPVs) of thoracic ultrasonography. Results: In this study, sensitivity, specificity, PPV, NPV, and accuracy of chest ultrasound (CUS) for PE diagnosis were 81.25%, 95%, 98.3%, 77.3% and 87% respectively. Conclusion: TUS is a bedside, safe, easily available, noninvasive method for early diagnosis of PE in emergency department and in situations where CTPE couldn't be used.