Transthoracic sonography for the detection of pulmonary embolism--a meta-analysis.
OBJECTIVE
Radiation protection is a major issue since the implementation of MSCT technology and its widespread indication for the detection of various diseases. In a European-wide trial (SECT) meta-analyses of imaging alternatives to CT have been initiated. This paper focuses on the diagnostic performance of transthoracic ultrasound (TUS) for the diagnosis of pulmonary embolism (PE) (5 studies, 652 patients).


METHODS
Medical literature (from 1990 to 2006) in PubMed and EMBASE databases was searched for articles on studies that used TUS as diagnostic tests for PE. Studies were included if they reported the positive and negative rates of PE diagnoses from TUS compared with the rates of PE in CT, MRI or a combination of diagnostic tests. Two readers assessed the quality of the studies.


RESULTS
Pooled sensitivity and specificity of TUS for PE were 80 % (95 % CI: 75 %, 83 %) and 93 % (95 % CI: 89 %, 96 %), respectively.


CONCLUSIONS
In the time of MSCT, TUS is an imaging modality that is no longer part of recent diagnostic algorithms for the diagnosis of PE. Considering the increasing number of requested CT examinations and therefore increasing collective radiation dose, this meta-analysis shows that TUS is a diagnostic alternative for special clinical settings in the work-up of suspected PE that seems to have fallen into oblivion.
Niemann
T
T
Radiology, University Hospital Basel, Petersgraben 4, Basel, Switzerland. niemannt@uhbs.ch
Egelhof
T
T
Bongartz
G
G
D000465:Algorithms; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed / Q000706:statistics & numerical data; D014463:Ultrasonography / Q000706:statistics & numerical data; D014600:Utilization Review / Q000706:statistics & numerical data