[Diagnostic workup for indicating the presence of pulmonary embolism: still not optimal].
Despite numerous studies, which have documented that only 25-30% of patients presenting with suspected pulmonary embolism actually have emboli, the tendency to overdiagnose and overtreat this disease remains. Findings from the study by Kamphuisen et al. (2002:2083-7) in consecutive patients with suspected pulmonary embolism (non-diagnostic ventilation perfusion scan) in a general training hospital, confirm that with an optimal collaboration between pulmonologists, internists, radiologists and nuclear specialists, who follow a previously agreed diagnostic work-up, the proportion of patients without a proper confirmation or exclusion of pulmonary embolism can be minimized. However, a more promising solution to the problem might be the implementation of a strategy consisting of anamnestic features, measurement of the D-dimer concentration in plasma, and spiral CT.
Büller
H R
HR
Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Vasculaire Geneeskunde, Meibergdreef 9, 1105 AZ Amsterdam.
D000792:Angiography; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D006801:Humans; D010348:Patient Care Team; D011655:Pulmonary Embolism / Q000175:diagnosis*; D015272:Pulmonary Medicine / Q000379:methods / Q000592:standards*; D011877:Radionuclide Imaging