Controversies in diagnosis of pulmonary embolism

Paul D. Stein, Henry Dirk Sostman, James E. Dalen, Dale L. Bailey, Marika Bajc, Samuel Z. Goldhaber, Lawrence R. Goodman, Alexander Gottschalk, Russell D. Hull, Fadi Matta, Massimo Pistolesi, Victor F. Tapson, John G. Weg, Philip S. Wells, Pamela K. Woodard

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

The approach to the diagnosis of acute pulmonary embolism (PE) is under constant revision with advances in technology, noninvasive approaches, and increasing awareness of the risks of ionizing radiation. Optimal approaches in some categories of patients are controversial. Data are insufficient for evidence-based recommendations. Therefore, this survey of investigators in the field was undertaken. Even among experts there were marked differences of opinion regarding the approach to the diagnosis of acute PE. Although CT pulmonary angiography was usually the imaging test of choice, the respondents were keenly aware of the dangers of ionizing radiation. In view of advances in scintigraphic diagnosis since the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) trial, ventilation/perfusion (V/Q) lung scans or perfusion scans alone and single photon emission computed tomography (SPECT) V/Q lung scans are often recommended. The choice depends on the patient's age, gender, and complexity of the findings on the plain chest radiograph.

Original languageEnglish (US)
Pages (from-to)140-149
Number of pages10
JournalClinical and Applied Thrombosis/Hemostasis
Volume17
Issue number2
DOIs
StatePublished - Apr 2011

Keywords

  • CT angiography
  • pulmonary embolism
  • SPECT scintigraphy
  • V/Q scans
  • venous thromboembolism
  • venous ultrasound

ASJC Scopus subject areas

  • Hematology

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