[Ultrasound in pulmonary embolism: killing three birds with one stone].
Pulmonary embolism remains a great diagnostic challenge. The value of different ultrasound methods is presented in this review. Regarding the accuracy of echocardiography, it shows a sensitivity of 41 - 50 % and a specifity of 90 % for unselected patients with suspicion of PE as a result. On the other hand, the sensitivity of echocardiography in cases of hemodynamic instable patients is very high. In a recent multicenter trial of thoracic ultrasound in diagnosis of pulmonary embolism on 352 patients the sensitivity amounts to 74 %, the specifity to 95 %, the positive predictive value to 95 %, negative predictive value to 75 % and accuracy to 84 %. Colour Doppler sonography with compression is a save modality ensuring the source of embolism in deep vein thrombosis. With suspicion of deep vein thrombosis the median sensitivity made up 95 % (38 - 100 %) and median specifity was 97 % (81 - 100 %). The combination of chest sonography, echocardiography and compression sonography of leg vein thrombosis enhances the sensitivity of sonography to 92 %, while this accuracy can not be reached with any other method.
Mathis
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Landeskrankenhaus Hohenems, Osterreich. gebhard.mathis@cable.vol.at
D003937:Diagnosis, Differential; D004562:Electrocardiography; D006801:Humans; D011237:Predictive Value of Tests; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D013909:Thorax / Q000000981:diagnostic imaging; D013927:Thrombosis / Q000150:complications / Q000000981:diagnostic imaging; D018615:Ultrasonography, Doppler, Color