Comparison of non-invasive diagnostic tests to multi-detector CT pulmonary angiography for the diagnosis of pulmonary embolism

Firdous, Naeem; Nasa, Prashant; Bansal, Avdhesh; Juneja, Deven; Kanwar, M.S.; Bera, M.L.

doi:10.1016/j.jcdr.2013.02.004

Cited by 10 publications

(7 citation statements)

References 28 publications

(19 reference statements)

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“…Of these, 93 studies were selected for eligibility through full-text assessment of which 62 studies were finally included 17–78. Six further studies were included by examining the reference list of included publications 79–84…”

Section: Resultsmentioning

confidence: 99%

Diagnostic accuracy of focused deep venous, lung, cardiac and multiorgan ultrasound in suspected pulmonary embolism: a systematic review and meta-analysis

Falster

Jacobsen

Coman

et al. 2021

Thorax

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ObjectiveTo determine the diagnostic accuracy of point-of-care ultrasound in suspected pulmonary embolism.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, Embase, CINAHL and Cochrane library were searched on 2 July 2020 with no restrictions on the date of publication. Subject headings or subheadings combined with text words for the concepts of pulmonary embolism, ultrasound and diagnosis were used.Eligibility criteria and data analysisEligible studies reported sensitivity and specificity of deep venous, lung, cardiac or multiorgan ultrasound in patients with suspected pulmonary embolism, using an adequate reference-test. Prospective, cross-sectional and retrospective studies were considered for eligibility. No restrictions were made on language. Studies were excluded if a control group consisted of healthy volunteers or if transesophageal or endobronchial ultrasound was used. Risk of bias was assessed using quality assessment of diagnostic accuracy studies-2. Meta-analysis of sensitivity and specificity was performed by construction of hierarchical summary receiver operator curves. I2 was used to assess the study heterogeneity.Main outcome measuresThe primary outcome was overall sensitivity and specificity of reported ultrasound signs, stratified by organ approach (deep venous, lung, cardiac and multiorgan). Secondary outcomes were stratum-specific sensitivity and specificity within subgroups defined by pretest probability of pulmonary embolism.Results6378 references were identified, and 70 studies included. The study population comprised 9664 patients with a prevalence of pulmonary embolism of 39.9% (3852/9664). Risk of bias in at least one domain was found in 98.6% (69/70) of included studies. Most frequently, 72.8% (51/70) of studies reported >24 hours between ultrasound examination and reference test or did not disclose time interval at all. Level of heterogeneity ranged from 0% to 100%. Most notable ultrasound signs were bilateral compression of femoral and popliteal veins (22 studies; 4708 patients; sensitivity 43.7% (36.3% to 51.4%); specificity 96.7% (95.4% to 97.6%)), presence of at least one hypoechoic pleural-based lesion (19 studies; 2134 patients; sensitivity 81.4% (73.2% to 87.5%); specificity 87.4% (80.9% to 91.9%)), D-sign (13 studies; 1579 patients; sensitivity 29.7% (24.6% to 35.4%); specificity 96.2% (93.1% to 98.0%)), visible right ventricular thrombus (5 studies; 995 patients; sensitivity 4.7% (2.7% to 8.1%); specificity 100% (99.0% to 100%)) and McConnell’s sign (11 studies; 1480 patients; sensitivity 29.1% (20.0% to 40.1%); specificity 98.6% (96.7% to 99.4%)).ConclusionSeveral ultrasound signs exhibit a high specificity for pulmonary embolism, suggesting that implementation of ultrasound in the initial assessment of patients with suspected pulmonary embolism may improve the selection of patients for radiation imaging.PROSPERO registration numberCRD42020184313.

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Section: Resultsmentioning

confidence: 99%

Diagnostic accuracy of focused deep venous, lung, cardiac and multiorgan ultrasound in suspected pulmonary embolism: a systematic review and meta-analysis

Falster

Jacobsen

Coman

et al. 2021

Thorax

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“…We combined clinical variables that can be observed in inpatients in real-time, including symptoms, signs and findings on frequently performed texts (e.g., electrocardiography, electrocardiogram (ECG), echocardiography, ultrasonic cardiogram (UCG), and blood gas levels). 20 Moreover, our rule is derived from a study involving a large multicenter cohort of inpatients with positive D-dimer results, and our test passed an external retrospective validation, demonstrating that it is credible and valid.…”

Section: Introductionmentioning

confidence: 81%

Diagnostic management of inpatients with a positive D‐dimer test: developing a new clinical decision‐making rule for pulmonary embolism

et al. 2021

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“…Therefore, right ventricular failure is a potent predictor of severity and prognosis of APE . CTPA is now widely used to evaluate APE, based on parameters of right ventricular function and morphology of interventricular septum …”

Section: Discussionmentioning

confidence: 99%

ECG‐gated pulmonary artery CTA for evaluation of right ventricular function in patients with acute pulmonary embolism

et al. 2016

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Comparison of non-invasive diagnostic tests to multi-detector CT pulmonary angiography for the diagnosis of pulmonary embolism

Cited by 10 publications

References 28 publications

Diagnostic accuracy of focused deep venous, lung, cardiac and multiorgan ultrasound in suspected pulmonary embolism: a systematic review and meta-analysis

Diagnostic accuracy of focused deep venous, lung, cardiac and multiorgan ultrasound in suspected pulmonary embolism: a systematic review and meta-analysis

Diagnostic management of inpatients with a positive D‐dimer test: developing a new clinical decision‐making rule for pulmonary embolism

ECG‐gated pulmonary artery CTA for evaluation of right ventricular function in patients with acute pulmonary embolism

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