Imaging evaluation for suspected pulmonary embolism: what do emergency physicians and radiologists say?
OBJECTIVE
The utility of various imaging techniques and strategies for the diagnosis of pulmonary embolism has been studied in randomized control trials and extensively described in the literature. CT and ventilation-perfusion scintigraphy are the mainstays of diagnosis, and MRI is emerging. The purpose of this study was to assess the diagnostic approach to pulmonary embolism practiced by emergency physicians and advised by radiologists.


METHODS
Questionnaires were sent to emergency physicians and radiologists in Pennsylvania. The questions covered diagnostic strategies for the detection of pulmonary embolism in the usual situations and in clinical circumstances in which the primary imaging technique is considered less desirable.


RESULTS
Sixty-two radiologists and 52 emergency physicians completed the survey. Ninety percent of radiologists and 96% of emergency physicians answered that CT was their first-line choice for the diagnosis of pulmonary embolism. The use of ventilation-perfusion scintigraphy increased in the care of patients with renal failure and allergy to iodinated contrast material. MRI was chosen infrequently.


CONCLUSIONS
CT is the overwhelmingly preferred technique for the diagnosis of pulmonary embolism. The role of ventilation-perfusion scintigraphy increases when the use of iodinated contrast material is contraindicated. MRI does not seem to have an important role in practice.
Jha
Saurabh
S
Department of Radiology, Hospital of the University of Pennsylvania, MRI Learning Center, 3400 Spruce St., Philadelphia, PA 19104, USA.
Ho
Alex
A
Bhargavan
Mythreyi
M
Owen
Jean B
JB
Sunshine
Jonathan H
JH
D003657:Decision Making; D003952:Diagnostic Imaging / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital; D006801:Humans; D010414:Pennsylvania; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011655:Pulmonary Embolism / Q000175:diagnosis*; D011871:Radiology; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires