Chest Ultrasound in Diagnosis of Pulmonary Embolism in Comparison to Helical CT

Abstract

CUS can improve diagnosis of pulmonary embolism. Sonography also reveals small infarcts which remain undetected with other imaging procedure such as helical CT.

Advances in the Diagnosis and Treatment of Pulmonary Embolism

“…Although the sonographic accuracy was more than 90%, these reports appear to have been overlooked for many years. More recently, several investigators have confirmed the original results [22, 23]. Since PE is a potentially fatal disease needing rapid onset of therapy, alternative easily accessible methods available to the physician at bedside may facilitate a swift diagnosis of PE.…”

Lung Ultrasound in the Evaluation of Patients with Pleuritic Pain in the Emergency Department

“…Lung parenchymal lesions due to embolism have some particular sonographic characteristics, and most of them are localized in an area of pleuritic chest pain (6 -8). Similar hypoechoic images are present in some other diseases of the lung, and false-positive chest ultrasound may derive from other peripheral consolidations of the lung, especially pneumonic or neoplastic infiltrates (7,8). In a recent study, Mohn and colleagues found some disappointing results about the accuracy of lung ultrasound in excluding or confirming pulmonary embolism (14).…”

“…Pleuritic pain is the most frequent presenting symptom of pulmonary embolism, but the latter is a condition that affects only a minority of patients admitted to the ED for the evaluation of thoracic pain (1)(2)(3)13). We know from literature review that lung ultrasound may be useful in the diagnosis of pulmonary embolism (5)(6)(7)(8). All these articles describe some parenchymal findings at lung ultrasound that are considered typical of peripheral lung infarct due to embolism.…”

“…This non-invasive bedside approach is easily performed in a few minutes by the emergency physician with a minimum of training. Despite a large number of articles about the usefulness of lung sonography in the diagnosis of pulmonary embolism, alveolar consolidation, and pneumothorax, we did not find any reference about the sonographic approach to distinguish different sources of pleuritic pain (5)(6)(7)(8)(9)(10)(11)(12). Moreover, we found no reports on the means for incorporating lung sonography into a diagnostic algorithm that combines pre-test probability, D-dimer, and imaging results by Bayesian reasoning in outpatients complaining of pleuritic pain who are selected to be tested for pulmonary embolism (4).…”

Aktuelle Entwicklungen in der Pneumologie 2002 - Teil 1

“…Charakteristische Verän-derungen sind ein bzw. typischerweise mehrere dreieckförmige, echoarme, intrapulmonal gelegene und meist glatt begrenzte Herde mit subpleuraler Basis und gelegentlich darstellbarem zentralen Bronchusreflex [104,135,136]. Daneben findet sich häufig ein zum Infarktbereich korrespondierender, umschriebener und bei größerer Ausdehnung auch ein basaler Pleuraerguss.…”