Chest Sonography in the Diagnosis of Pulmonary Embolism: A 
			 Comparison with MRI Angiography and Ventilation Perfusion Scintigraphy

Lechleitner, Peter; Riedl, B.; Raneburger, W.; Gamper, Gunnar; Theurl, A.; Lederer, Andri

doi:10.1055/s-2002-36173

Cited by 39 publications

(29 citation statements)

References 13 publications

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“…Sonographic findings of PE on transthoracic US (TUS) are well described [13][14][15][16][22][23][24][25][26][27][28][29] and correlate with the pathophysiologic results found on autopsy in patients diagnosed with PE and on helical CT. 28,30,31 Sonomorphology can be divided into parenchymal and pleural pathology. Typical parenchymal pathology includes multiple hypoechoic areas of lung tissue extending to the pleura.…”

Section: Discussionmentioning

confidence: 99%

“…13,14,[28][29][30] Pleural findings consist of localized or basal pleural effusions and can be found in up to two-thirds of patients with PE. [22][23][24][25][26][27] They correspond to the site of the parenchymal lesion. 14,[22][23][24][25][26][27][28][29] Interestingly, several investigators have found that the majority of detected PEs are found in the lower lung lobes, also noting that the localization of the parenchymal and pleural defects correlate with the area of pleuritic chest pain.…”

Section: Discussionmentioning

confidence: 99%

“…[22][23][24][25][26][27] They correspond to the site of the parenchymal lesion. 14,[22][23][24][25][26][27][28][29] Interestingly, several investigators have found that the majority of detected PEs are found in the lower lung lobes, also noting that the localization of the parenchymal and pleural defects correlate with the area of pleuritic chest pain. 22,24,25 Given the rising concern over radiation exposure and projected increased cancer risk, 8,10,11 it is not surprising that investigators have sought to determine if TUS can be used as an alternative or complementary imaging modality for PE.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Bedside Transthoracic Sonography in Suspected Pulmonary Embolism: A New Tool for Emergency Physicians

Hoffmann¹,

Gullett²

2010

Academic Emergency Medicine

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Bedside Transthoracic Sonography in Suspected Pulmonary Embolism: A New Tool for Emergency Physicians

Hoffmann¹,

Gullett²

2010

Academic Emergency Medicine

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“…This translates to a positive predictive value of 95 % and a negative predictive value of 75 %. Another study supported these results, finding that the presence of round or wedge-shaped densities on thoracic ultrasound is predictive of PE (sensitivity 81 %, specificity 84 %) [14]. In both studies, the incidence of PE was high (55.1 and 65.5 %, respectively) and therefore the positive predictive value may be lower in a general ICU population with a lower incidence of PE.…”

Section: Pulmonary Embolismmentioning

confidence: 72%

New Diagnostic Capabilities of Ultrasound in the Intensive Care Unit

Hlaing

Panzer

2015

Curr Anesthesiol Rep

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Bedside critical care ultrasound has performance similar to traditional tests in diagnosing certain pathologies such as pleural effusion, pericardial effusion, pneumothorax, global cardiac dysfunction, and deep venous thrombosis. In this review article, we will provide an update of ultrasound's performance in assessing other pathologies. Specifically, we will discuss the diagnostic performance of ultrasound in the diagnosis of pulmonary embolism, pulmonary edema, and alveolar collapse; in evaluating readiness for extubation; and in predicting fluid responsiveness. These topics were chosen for their importance in the daily management of critically ill patients. A review of recent studies will show that ultrasound is a promising tool for the intensivist in these clinical settings.

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“…On the other hand, ventilation/perfusion lung scan is often not sufficiently conclusive [6][7][8], although it is sometimes used [9,10].…”

mentioning

confidence: 99%

Usefulness of chest ultrasonography in detecting pulmonary embolism in patient with chronic obstructive pulmonary disease and chronic renal failure: a case report

Zanobetti¹,

Bigiarini²,

Coppa³

et al. 2012

The American Journal of Emergency Medicine

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We describe the case of a 75-year-old man affected by a chronic obstructive pulmonary disease and chronic renal failure admitted to our emergency department for dyspnea and interscapular stabbing pain. Chest radiography showed diffuse parenchymal consolidation in the lower right lung with bronchiectasis, but the treatment for infection disease did not improve the clinical conditions of the patient. According to Wells score indicating an intermediate risk for pulmonary embolism, we performed a chest ultrasonography that showed ultrasonographic patterns of thromboembolism. Because the presence of chronic renal failure limited the execution of a helical computed tomographic pulmonary angiography, a pulmonary scintigraphy was performed confirming the diagnosis of pulmonary embolism. Our case suggested that chest ultrasonography can be a valuable tool for early detection of pulmonary embolism and to establish immediately an appropriate therapy.Pulmonary embolism is a common and potentially lethal cardiopulmonary disease with nonspecific signs and symptoms [1] so that its diagnosis could be difficult and requires a high index of clinical suspicion by the emergency physician and is, therefore, frequently underdiagnosed and undertreated [2]. Chest radiography is the first imaging diagnostic modality used in the emergency department (ED), although it may often show nonspecific and indirect signs or it may even be normal.Pulmonary angiography is currently the criterion standard [3], but it is rarely used because of its invasive nature and the relative high risk of complications [4].Helical computed tomographic pulmonary angiography (HCTPA) has been recently established as the reference modality, with high sensitivity and specificity [3], but it has limitations in detecting injury in subsegmental arteries [5].On the other hand, ventilation/perfusion lung scan is often not sufficiently conclusive [6][7][8], although it is sometimes used [9,10].However, critically ill patients may sometimes not tolerate any of these diagnostic modalities, or adequate equipment might not be available in the ED.In these cases, chest ultrasonography that exhibited high sensitivity [3] can play a useful role in directing the physician to formulate the correct diagnosis and to optimize the treatment, improving the prognosis.A 75-year-old man was admitted to our ED for dyspnea and interscapular stabbing pain, exacerbated by deep inspiration and cough, started 3 weeks ago.The patient was a former smoker and had a history of right pleurisy and spontaneous pneumothorax and was affected by a chronic obstructive pulmonary disease and a chronic renal failure syndrome. In the last 3 months, the patient was treated twice for a pulmonary infection by Pseudomonas aeruginosa.Vital signs at admission were heart rate of 75 beats per minute, blood pressure of 165/80 mm Hg, respiratory rate of 22 breaths per minute, oxygen saturation of 96% during oxygen administration (2 L/min) by nasal probes, Glasgow Coma Scale of 15, and no fever.The patient was tach...

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Chest Sonography in the Diagnosis of Pulmonary Embolism: A Comparison with MRI Angiography and Ventilation Perfusion Scintigraphy

Abstract: 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.

Cited by 39 publications

References 13 publications

Bedside Transthoracic Sonography in Suspected Pulmonary Embolism: A New Tool for Emergency Physicians

Bedside Transthoracic Sonography in Suspected Pulmonary Embolism: A New Tool for Emergency Physicians

New Diagnostic Capabilities of Ultrasound in the Intensive Care Unit

Usefulness of chest ultrasonography in detecting pulmonary embolism in patient with chronic obstructive pulmonary disease and chronic renal failure: a case report

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