UNIGE document Scientific Article
previous document  unige:1838  next document
add to browser collection

Challenges in the diagnosis of acute pulmonary embolism

Stein, Paul D.
Sostman, H. Dirk
Buller, Harry R.
Chenevert, Thomas L.
Dalen, James E.
Goodman, Lawrence R.
Gottschalk, Alexander
show hidden authors show all authors [1 - 14]
Published in American Journal of Medicine. 2008, vol. 121, no. 7, p. 565-571
Abstract The state of the art of diagnostic evaluation of hemodynamically stable patients with suspected acute pulmonary embolism was reviewed. Diagnostic evaluation should begin with clinical assessment using a validated prediction rule in combination with measurement of D-dimer when appropriate. Imaging should follow only when necessary. Although with 4-slice computed tomography (CT) and 16-slice CT, the sensitivity for detection of pulmonary embolism was increased by combining CT angiography with CT venography, it is not known whether CT venography increases the sensitivity of 64-slice CT angiography. Methods to reduce the radiation exposure of CT venography include imaging only the proximal leg veins (excluding the pelvis) and obtaining discontinuous images. Compression ultrasound can be used instead. In young women, radiation of the breasts produces the greatest risk of radiation-induced cancer. It may be that scintigraphy is the imaging test of choice in such patients, but this pathway should be tested prospectively. A patient-specific approach to the diagnosis of pulmonary embolism can be taken safely in hemodynamically stable patients to increase efficiency and decrease cost and exposure to radiation.
Keywords Acute DiseaseDecision Support TechniquesDiagnostic ImagingFibrin Fibrinogen Degradation Products/analysisHumansLung/pathologyPulmonary Embolism/diagnosis
PMID: 18589050
Full text
Article (Author postprint) (135 Kb) - document accessible for UNIGE members only Limited access to UNIGE
Research groups Geneva Platelet Group (13)
La maladie thromboembolique veineuse (808)
(ISO format)
STEIN, Paul D. et al. Challenges in the diagnosis of acute pulmonary embolism. In: American Journal of Medicine, 2008, vol. 121, n° 7, p. 565-571. https://archive-ouverte.unige.ch/unige:1838

202 hits

0 download


Deposited on : 2009-05-29

Export document
Format :
Citation style :