Document Detail


Diagnostic strategies in acute pulmonary embolism.
MedLine Citation:
PMID:  8495869     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A firm diagnosis of pulmonary embolism (PE) to prevent over- or undertreatment requires an integrated use of ventilation-perfusion lung scintigraphy (V/Q scan), a recent chest X-ray, bilateral selective pulmonary angiography and venous studies. The V/Q scan should be reported in terms of probabilities according to defined criteria and be combined with clinical probabilities before a treatment decision is made. A negative V/Q scan, a low-probability scan combined with low clinical suspicion or a high-probability scan with a high clinical suspicion is generally conclusive. Patients with intermediate (indeterminate) scan probability or with discordant scintigraphic clinical probability need further work-up with pulmonary angiogram or venous studies. If neither scintigraphy nor pulmonary angiography is available, accurate venous studies of the lower legs may guide treatment decision in patients suspected of having PE. We need more research to define if all patients with PE but only a minor or no clot burden proven by venous studies really need treatment.
Authors:
U Nyman
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Publication Detail:
Type:  Journal Article; Multicenter Study; Review    
Journal Detail:
Title:  Haemostasis     Volume:  23 Suppl 1     ISSN:  0301-0147     ISO Abbreviation:  Haemostasis     Publication Date:  1993 Mar 
Date Detail:
Created Date:  1993-06-21     Completed Date:  1993-06-21     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0371574     Medline TA:  Haemostasis     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  220-6     Citation Subset:  IM    
Affiliation:
Department of Diagnostic Radiology, University of Lund, Malmö General Hospital, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Angiography / adverse effects
Diagnosis, Differential
Humans
Lung Diseases, Obstructive / radionuclide imaging
Predictive Value of Tests
Prospective Studies
Pulmonary Artery / radiography
Pulmonary Embolism / etiology,  radiography,  radionuclide imaging*
Reproducibility of Results
Sensitivity and Specificity
Thrombophlebitis / complications,  diagnosis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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