Plasma D-dimer in suspected pulmonary embolism: a comparison with pulmonary angiography and ventilation--perfusion scintigraphy.
The diagnosis of pulmonary embolism remains a difficult issue. In a previous study of patients submitted to ventilation--perfusion (V-P) scintigraphy we suggested that measurement of D-dimer might be of value for ruling out the diagnosis of pulmonary embolism if the plasma level was less than 500 micrograms/l (ELISA). In the present paper, this cut-off was validated in a consecutive series of 21 patients who were submitted to pulmonary angiography. Sensitivity and specificity were 100% and 36%, respectively. When these data were pooled with the results obtained following V-P scintigraphy (total number of patients = 67), sensitivity, specificity, and positive and negative predictive values were 100%, 70%, 59% and 100%, respectively. It is therefore worthwhile to further evaluate the value of the plasma measurement of D-dimers, especially in patients with inconclusive lung scintigraphy.
Bounameaux
H
H
Department of Medicine, University Hospital of Geneva, Switzerland.
Schneider
P A
PA
Slosman
D
D
de Moerloose
P
P
Reber
G
G
D015901:Angiography, Digital Subtraction; D004797:Enzyme-Linked Immunosorbent Assay; D005069:Evaluation Studies as Topic; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D011237:Predictive Value of Tests; D011655:Pulmonary Embolism / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D014692:Ventilation-Perfusion Ratio
D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D