Subsegmental Pulmonary Embolism: Value of Thoracic Ultrasound for Diagnosis and Follow-Up

Mastruzzo, Claudio; Perracchio, Guido; Poidomani, Grazia; Romano, Marcello; Crimi, Nunzio; Vancheri, Carlo

doi:10.2169/internalmedicine.47.1085

Cited by 10 publications

(12 citation statements)

References 17 publications

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“…Although, this method due to its good performance in the diagnosis of PE is highly recommended by emergency medicine specialists, but studies in this field are limited. [ 13 14 15 16 17 18 ]…”

Section: Introductionmentioning

confidence: 99%

Diagnostic validity of ultrasonography in evaluation of pulmonary thromboembolism

Abootalebi¹,

Golshani²,

Karami³

et al. 2016

Adv Biomed Res

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Background:Diagnosis of pulmonary embolism (PE) remains difficult due to its nonspecific symptoms and signs. Therefore, many patients die undiagnosed or untreated. We decided to study the sensitivity, specificity, and accuracy of ultrasonography in the diagnosis of pulmonary thromboembolism.Materials and Methods:In this prospective study, 77 patients with clinically suspected PE in the emergency department of Isfahan Al-Zahra Hospital were enrolled from September 2011 to September 2012. At first, they were evaluated by thoracic ultrasonography (TUS) and then divided into four groups based on their TUS findings. Multi-slice computed tomography (MSCT) was the reference method in this study performed within 24 h from admission. MSCT scans were interpreted by a radiologist who was unaware of the TUS results. Sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPVs) of thoracic ultrasonography were determined.Results:PE diagnosis was confirmed by MSCT in 25 patients and 54 hypoechoic lesions were detected by TUS with the average size of 16.4 mm × 11.1 mm. In our study, sensitivity, specificity, PPV, NPV, and accuracy of TUS for PE diagnosis were 84%, 94.2%, 87.5%, and 92.5%, respectively.Conclusion:TUS is an inexpensive, safe and easily available method for timely diagnosis and treatment of PE in emergency department and its NPV is high for cases with low scores for Wells criteria who had a normal or possible TUS findings. It is also specific in the diagnosis of PE in cases with high scores Wells criteria who have confirmed or probable TUS findings.

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Section: Introductionmentioning

confidence: 99%

Diagnostic validity of ultrasonography in evaluation of pulmonary thromboembolism

Abootalebi¹,

Golshani²,

Karami³

et al. 2016

Adv Biomed Res

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“…

Background: Pulmonary thromboembolism (PTE) remains under-diagnosed fatal disease at emergency units suggesting the need for alternative, easy, and noninvasive bedside diagnostic approaches.

Objectives: To determine the diagnostic role of gray-scale and color Doppler transthoracic ultrasonography (TUS) in patients with PTE.

Patients and Methods: Blinded to 64 multi-detectors CT pulmonary angiography (MDCTPA) examination as a gold standard, 60 patients with clinically suspected PTE underwent gray-scale and then color Doppler TUS examination. 3 Computed tomography pulmonary angiography (CTPA) is considered the gold standard for the diagnosis. TUS showed typical lesions in 33 patients with the mean of 2 lesions per patient.

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mentioning

confidence: 99%

“…2 Early diagnosis of PTE is important because prompt appropriate management can decrease mortality but is often confounded by nonspecific clinical presentation. 3 Computed tomography pulmonary angiography (CTPA) is considered the gold standard for the diagnosis. Unfortunately CTPA is expensive, not widespread enough cannot be 474 |…”

mentioning

confidence: 99%

Acute pulmonary thromboembolism in emergency room: gray‐scale versus color doppler ultrasound evaluation

Ghanem

Makhlouf

Hasan

et al. 2016

Clinical Respiratory J

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“…[3] Timely diagnosis of PE is crucial because prompt appropriate managment can decrease mortality but is often confounded by nonspecific clinical pesentation. [4]…”

mentioning

confidence: 99%

“…[4] The combination of clinical probability, ventilation-perfusion lung scanning, and lower extremity sonography has simplified the diagnostic approach. Although lung scanning, computed tomography pulmonary angiography (CTPA), and pulmonary angiography are important for the diagnosis, unfortunately they are not widespread enough and cannot be reached at the emergency units, also time factor is important.…”

mentioning

confidence: 99%

The role of thoracic ultrasonography in the diagnosis of pulmonary embolism

et al. 2013

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OBJECTIVES:The diagnosis of pulmonary embolism (PE) is still a problem especially at emergency units. The purpose of study was to determine the diagnostic accuracy of thoracic ultrasonography (TUS) in patients with PE.METHODS:In this prospective study, 50 patients with suspected PE were evaluated in Department of Pulmonary Diseases of a Training and Reasearch Hospital between January 2010 and July 2011. At the begining, TUS was performed by a chest physician, subsequently for definitive diagnosis computed tomography pulmonary angiography were performed in all cases as a reference method. Other diagnostic procedures were examination of serum d-dimer levels, echocardiography, and venous doppler ultrasonography of the legs. Both chest physician and radiologist were blinded to the results of other diagnostic method. Diagnosis of PE was suggested if at least one typical pleural-based/subpleural wedge-shaped or round hypoechoic lesion with or without pleural effusion was reported by TUS. Presence of pure pleural effusion or normal sonographic findings were accepted as negative TUS for PE.RESULTS:PE was diagnosed in 30 patients. It was shown that TUS was true positive in 27 patients and false positive in eight and true negative in 12 and false negative in three. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of TUS in diagnosis of PE for clinically suspected patients were 90%, 60%, 77.1%, 80%, and 78%, respectively.CONCLUSIONS:TUS with a high sensitivity and diagnostic accuracy, is a noninvasive, widely available, cost-effective method which can be rapidly performed. A negative TUS study cannot rule out PE with certainty, but positive TUS findings with moderate/high suspicion for PE may prove a valuable tool in diagnosis of PE at bedside especially at emergency setting, for critically ill and immobile patients, facilitating immediate treatment decision.

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Subsegmental Pulmonary Embolism: Value of Thoracic Ultrasound for Diagnosis and Follow-Up

Abstract: Abstract

Cited by 10 publications

References 17 publications

Diagnostic validity of ultrasonography in evaluation of pulmonary thromboembolism

Diagnostic validity of ultrasonography in evaluation of pulmonary thromboembolism

Acute pulmonary thromboembolism in emergency room: gray‐scale versus color doppler ultrasound evaluation

The role of thoracic ultrasonography in the diagnosis of pulmonary embolism

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