title: The role of spiral computed tomography and D-dimer in pulmonary embolism.
abstract: The first part of this study retrospectively compared the discriminatory power of spiral CT versus clinical findings in 112 consecutive patients referred with chest pain or dyspnoea. Spiral CT exhibited a sensitivity 91.9%; specificity 98.7%; PPV 97.1%; NPV 96.1%; accuracy 96.4%. No other test or clinical parameter had acceptable accuracy. The SimpliRED test is a latex method of estimating the level of D-dimer. The second part of this study determined that, in a similar consecutive series of patients referred for lung scintigrams, although SimpliRED tests had a NPV 95.5%, 59/126 (46.8%) consecutive were positive. However on the basis of clinical effectiveness and cost, imaging for suspected pulmonary embolism should be based on a combination of D-dimer estimation and spiral CT.
authors: Department of Radiology, Western Infirmary, Glasgow G11 6NT. fgalf@clinmed.gla.ac.uk
authors: F G
authors: FG
authors: Adams
mesh_terms: D002637:Chest Pain / Q000209:etiology; D004417:Dyspnea / Q000209:etiology; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000097:blood / Q000175:diagnosis*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D