CLINICAL SIGNIFICANCE OF COMBINED VENTILATION-PERFUSION LUNG SCAN AND COMPRESSION ULTRASONOGRAPHY IN THE MANAGEMENT OF PATIENTS WITH SUSPECTED PULMONARY EMBOLISM.

1999 ◽  
Vol 24 (3) ◽  
pp. 217
Author(s):  
S. Dadparvar ◽  
R. M. Magno ◽  
J. C. Sabatino ◽  
M. Pan ◽  
A. A. Shaikh ◽  
...  
1993 ◽  
Vol 70 (03) ◽  
pp. 408-413 ◽  
Author(s):  
Edwin J R van Beek ◽  
Bram van den Ende ◽  
René J Berckmans ◽  
Yvonne T van der Heide ◽  
Dees P M Brandjes ◽  
...  

SummaryTo avoid angiography in patients with clinically suspected pulmonary embolism and non-diagnostic lung scan results, the use of D-dimer has been advocated. We assessed plasma samples of 151 consecutive patients with clinically suspected pulmonary embolism. Lung scan results were: normal (43), high probability (48) and non-diagnostic (60; angiography performed in 43; 12 pulmonary emboli). Reproducibility, cut-off values, specificity, and percentage of patients in whom angiography could be avoided (with sensitivity 100%) were determined for two latex and four ELISA assays.The latex methods (cut-off 500 μg/1) agreed with corresponding ELISA tests in 83% (15% normal latex, abnormal ELISA) and 81% (7% normal latex, abnormal ELISA). ELISA methods showed considerable within- (2–17%) and between-assay Variation (12–26%). Cut-off values were 25 μg/l (Behring), 50 μg/l (Agen), 300 μg/l (Stago) and 550 μg/l (Organon). Specificity was 14–38%; in 4–15% of patients angiography could be avoided.We conclude that latex D-dimer assays appear not useful, whereas ELISA methods may be of limited value in the exclusion of pulmonary embolism.


1975 ◽  
Author(s):  
M. Hume

100 post-operative subjects were observed following total hip replacement using 125I-fibrinogen (125I-Fg) and impedance plethysmography (IPG) with thigh cuff. Phlebo-grams were obtained if these tests indicated venous thrombosis. Also, lung scan was obtained if clinical evidence of pulmonary embolism developed. Sustained significant isotope localization occurred in 40. 32 of these had abnormal IPG. Four patients had minor pulmonary embolism, which was associated with abnormality of either 125I-Fg or IPG. All major obstructive venous thrombosis and all moderately extensive thrombosis was associated with abnormal IPG. Only minute thrombi were not correctly classified by IPG. The following conclusions are supported by this experience. 1) If prospectively applied in patients at risk, the combination of both techniques (125I-Fg, IPG) is capable of detecting all silent venous thrombosis even minute thrombi of negligible significance. 2) IPG is capable of detecting all major obstructive and all moderately extensive thrombi, that is, all thrombosis of clinical significance arising in the leg. 3) Minute thrombi will not be detected by IPG alone and small emboli resulting from detachment of such minute thrombi would be unheralded unless monitoring includes 125I-Fg.


2000 ◽  
Vol 84 (12) ◽  
pp. 973-976 ◽  
Author(s):  
Bernd-Jan Sanson ◽  
Harry Büller ◽  
Dees P. Brandjes ◽  
Melvin Mac Gillavry ◽  

SummaryWe performed a multi-center study in consecutive patients with suspected pulmonary embolism to compare the diagnostic accuracy of a two-point compression ultrasonography (only the common femoral vein and popliteal vein) with an extensive examination of compressibility (from the common femoral vein until the trifurcation of calf veins). A total of 479 patients underwent the two-point compression ultrasonography. The prevalence of pulmonary embolism was 32%. The sensitivity and specificity of this procedure were 23% (95% CI 19-26) and 98% (95% CI 96-99), respectively. Extensive compression ultrasonography was performed in 461 (96%) of these 479 patients and showed comparable accuracy indices (sensitivity 25%, 95% CI 20-28 and specificity 97%, 95% CI 95-99). We conclude that compression ultrasonography has a limited sensitivity for the detection of thrombosis in patients with acute pulmonary embolism within 24 h of presentation. A more extensive assessment of compressibility of the leg veins in these patients has no additional value as compared to the two-point assessment.


2008 ◽  
Vol 35 (6Part5) ◽  
pp. 2675-2676
Author(s):  
J Blechinger ◽  
B Harkness ◽  
D Peck ◽  
A Jackson

CHEST Journal ◽  
1982 ◽  
Vol 82 (4) ◽  
pp. 411-415 ◽  
Author(s):  
Michael S. Kipper ◽  
Kenneth M. Moser ◽  
Keith E. Kortman ◽  
William L. Ashburn

1990 ◽  
Vol 5 (4) ◽  
pp. 285-291 ◽  
Author(s):  
Daniel M. Becker ◽  
John T. Philbrick ◽  
Frances W. Schoonover ◽  
C. David Teates

1980 ◽  
Vol 5 (11) ◽  
pp. 508-513 ◽  
Author(s):  
JOHN R. HOEY ◽  
PAUL A. FARRER ◽  
LEONARD J. ROSENTHALL ◽  
ROBERT F. SPENGLER

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