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Ultraschall Med. 2002 Dec;23(6):373-8.

Chest sonography in the diagnosis of pulmonary embolism: a comparison with MRI angiography and ventilation perfusion scintigraphy.

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1
A.O. Krankenhaus Lienz, Germany.

Abstract

AIM:

To compare the diagnostic performance of chest sonography, MRI angiography and ventilation/perfusion intigraphy in pulmonary embolism (PE).

METHOD:

In a prospective clinical study, 55 patients (41 women, 14 men, age 23 - 91 years) with clinical signs of PE were investigated within 48 hours of the onset of symptoms. The final diagnosis was made by MRI angiography (reference method).

RESULTS:

PE was diagnosed in a total of 36 patients. Chest sonography revealed rounded or wedge-shaped hypoechoic lesions in 30 patients. On ventilation/perfusion (V/P) scintigraphy, 41 patients had positive V/P scans, but only 23 were of high probability. Chest ultrasound had a positive predictive value of 97 % to diagnose PE. The sensitivity, specificity, the negative predictive value and accuracy were 81 %, 84 %, 84 % and 82 %, respectively. As 18 patients had inconclusive scans, the diagnostic performance of ventilation/perfusion scintigraphy was poor. The positive predictive value, sensitivity and specificity were 58 %, 42 % and 91 %, respectively. Patients in whom PE was excluded mainly suffered from congestive heart failure, bronchopulmonary infections or pulmonary hypertension.

CONCLUSION:

A negative sonographic study cannot rule out PE with certainty. However, a chest sonography is of acceptable diagnostic value in patients with suspected PE and may be used as an adjunct or guide to more established methods.

PMID:
12514752
DOI:
10.1055/s-2002-36173
[Indexed for MEDLINE]

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