title: Comparison of non-invasive diagnostic tests to multi-detector CT pulmonary angiography for the diagnosis of pulmonary embolism.
abstract: BACKGROUND
  Acute pulmonary embolism (PE) remains a diagnostic and therapeutic challenge to physicians. There are various non-invasive diagnostic modalities been suggested to diagnose pulmonary embolism.
  
  
  OBJECTIVE
  We tried to find the performance of various non-invasive investigations in comparison to multi-detector Computerized Tomography (MDCT pulmonary angiography for the diagnosis of PE).
  
  
  METHODS
  A prospective cohort study was conducted in 80 hospitalized medical patients.
  
  
  METHODS
  There were 80 patients with Wells score > 2 who were included. The demographic data, non-invasive investigations, and MDCT pulmonary angiography were conducted in these patients. The sensitivity (SEN), specificity (SPE), positive predictive value (PPV), and negative predictive value (NPV) were calculated for each test.
  
  
  RESULTS
  Out of 80 patients, 77.5% patients were with Wells score 3-6 and 22.5% patients were with Wells score more than 6. The test with highest sensitivity was d-dimer (SEN - 90%, P = 0.091) followed by PAH on TTE (SEN - 83%, PPV - 86%, P = 0.006). The most specific test was ECG showing S1Q3T3 (SPE - 100%, P = 0.421), followed by Wells score > 6 (SPE - 91%, P = 0.211). There was no test with sensitivity and specificity more than 90%
  
  
  CONCLUSIONS
  In all patients with intermediate to high-risk probability MDCT pulmonary angiography is the most accurate test to diagnose PE and should be performed at the earliest. The combination of 2-dimensional ECHO and d-dimer can be used in patients with a high clinical suspicion of PE on pre-test probability where MDCT pulmonary angiography is not possible.
authors.affiliation: Department of Respiratory and Sleep Medicine, Indraprastha Apollo Hospital, India.
authors.forename: Naeem
authors.initials: N
authors.lastname: Firdous
authors.forename: Prashant
authors.initials: P
authors.lastname: Nasa
authors.forename: Avdhesh
authors.initials: A
authors.lastname: Bansal
authors.forename: Deven
authors.initials: D
authors.lastname: Juneja
authors.forename: Manjit Singh
authors.initials: MS
authors.lastname: Kanwar
authors.forename: Moti Lal
authors.initials: ML
authors.lastname: Bera
keywords: MDCT pulmonary angiography; Non-invasive investigations; Pulmonary embolism
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