Sonographic observation of pulmonary infarction and early infarctions by pulmonary embolism.
Fifty-eight consecutive patients with clinical symptoms of pulmonary embolism/infarction were examined by ultrasound as the first imaging modality. The diagnosis was confirmed in 35 patients by ventilation-perfusion scintigraphy; 13 underwent pulmonary angiography for verification of clinical diagnosis. Seven patients died, necropsy was performed and the diagnosis of pulmonary embolism was confirmed in six cases; three patients were submitted to transthoracic lung biopsy. Intercostal space and an additional small pleural effusion in 48% of the examined patients served as a sonic window for the 5 MHz sector scanner. In 42 of the 54 cases with a final diagnosis of pulmonary embolism/infarction a total of 69, hypoechoic, lesions with a pleural basis were detected. These were conspicuous, predominantly triangular, of a mean size 4.6 x 3.7 cm (range 9 x 8 to 2 x 1.5). A hyperechoic structure with reverberation artefacts suggestive of air was frequently visible in the centre: a sign of segmental involvement. The ultrasound examination yielded a true positive result in 41 cases. The overall sensitivity was 98% and the specificity 66%. The prevalence of pulmonary embolism was 83% and the diagnostic accuracy 90%. This suggests that chest sonography can be an efficient technique in the detection of pulmonary infarction.
Mathis
G
G
Department of Internal Medicine, City Hospital of Hohenems Institute for Nuclear Medicine LKH Feldkirch.
Metzler
J
J
Fussenegger
D
D
Sutterlütti
G
G
Feurstein
M
M
Fritzsche
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D003937:Diagnosis, Differential; D004452:Echocardiography; D005260:Female; D006801:Humans; D007238:Infarction / Q000000981:diagnostic imaging*; D008168:Lung / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D014692:Ventilation-Perfusion Ratio / Q000502:physiology