1997
DOI: 10.2214/ajr.169.5.9353458
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Treatment of patients with suspected pulmonary embolism and intermediate-probability lung scans: is diagnostic imaging underused?

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Cited by 44 publications
(16 citation statements)
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“…In 1982, Sostman et al [2] described finding that only 50 (12%) of 434 patients underwent pulmonary angiography despite unresolved diagnosis after scintigraphy. More recently, Khorasani et al [3] found that 63% of patients with lung scansshowing in termediate probability of embolism had treatment decisions made without benefit of a definitive imaging diagnosis.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…In 1982, Sostman et al [2] described finding that only 50 (12%) of 434 patients underwent pulmonary angiography despite unresolved diagnosis after scintigraphy. More recently, Khorasani et al [3] found that 63% of patients with lung scansshowing in termediate probability of embolism had treatment decisions made without benefit of a definitive imaging diagnosis.…”
Section: Discussionmentioning
confidence: 99%
“…Diagnosis of pulmonary embolism is basedlargely on noninvasiveimaging such as ventilationâ€"perfusion scintigraphy and lower extremity venous sonography, with a limited useof pulmonaryangiography [2,3]. Despite excellent results for helical and elec tron beam CT in central or segmental yes sels, with a sensitivity of 86â€"100% and a specificityof 78â€"95% [5, 7, 8], andcompara ble results for gadolinium-enhanced MR an giography (sensitivity, 75â€"100%; specificity, 95â€"100%) [9], little change has occurred in the diagnostic algorithm for pulmonary em bolism.…”
Section: Discussionmentioning
confidence: 99%
“…Whether the findings of the examinations would have been positive is a matter for speculation, because the lower ex tremity veins were not examined in the autop sies. Khorasani et al [14] recently showed that, in up to 49% of a population of patients with intermediate-probability lung scintigra phy, additional imaging with either sonogra phy or pulmonary arteriography was not done to exclude the diagnosis of pulmonary embo lism. These data are for patients with a 30-40%…”
Section: Diagnostic Imaging and Autopsy Findings For Pulmonary Embolismmentioning
confidence: 99%
“…If the diagnosis is still unclear, the patient would undergo pulmonary angiography, a procedure which carries a small but definite risk [15]. This diagnostic algorithm, however, was generally underused [4,16,17,18,19]. In the beginning of the 1990s it was stressed that there is a clear need for a technique, which is accurate, safe, noninvasive, easily and rapidly performed, widely accepted, and cost-effective, for direct detection and demonstration of intraluminal PE [20,21,22].…”
Section: Introductionmentioning
confidence: 99%