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Cost calculation under defined economical aspects leads to cost transparency for clinical ultrasound examinations. Echocardiography costs were calculated like this for the first time in Germany. Calculation based on fixed and variable cost aspects as well as using distinct scenarios enables prospective planning of resources and investment. The analysis points out deficits in the reimbursement of ultrasound examinations in Germany.

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1. tentative diagnosis of pulmonary embolism by clinical signs (n = 47) 2. only chest pain in breathing (n = 32), 3. deep vein thrombosis without signs of pulmonary embolism (n = 21). In 67 cases perfusion lung scans ware available. The typical sonographic sign is a wedge-shaped echo-poor lesion with or without a local effusion. In the first group, both methods coincided positively in 28 cases, whereas only the scan detected pulmonary embolism in 6 cases. In the second group, 8 cases were found by ultrasound, only 3 by scan. 6 patients from the third group showed pulmonary embolism sonographically. Multiple pulmonary embolism can be shown by both methods in a comparable percentage. False negative findings by ultrasound are to be expected in perfusion lesions of nearly one lobe of the lung or more, whereas contrariwise small signal embolism causes more often negative scans. Ultrasound is a additional, easily available and even alternative method of detecting pulmonary embolism, especially in case of doubt or if lung scan is not feasible.

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