Diagnosis of pulmonary embolism: When is imaging needed?

Clinics in Chest Medicine

Volumn 24, Issue 1, 2003, Pages 13-28

  Wells, Philip S ^a   Rodger, Marc ^a  

^a UNIVERSITY OF OTTAWA   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

D DIMER;

ALGORITHM; ANGIOGRAPHY; CLINICAL EXAMINATION; COMPUTER ASSISTED TOMOGRAPHY; DEEP VEIN THROMBOSIS; DIAGNOSTIC IMAGING; DIAGNOSTIC TEST; ECHOGRAPHY; EMBOLISM; ENZYME LINKED IMMUNOSORBENT ASSAY; HUMAN; LUNG ANGIOGRAPHY; LUNG EMBOLISM; LUNG SCINTISCANNING; LUNG VENTILATION PERFUSION RATIO; PRIORITY JOURNAL; PROGNOSIS; REVIEW; SPIRAL COMPUTER ASSISTED TOMOGRAPHY; ULTRASOUND;

EID: 0037344557     PISSN: 02725231     EISSN: None     Source Type: Journal    
DOI: 10.1016/S0272-5231(02)00052-7     Document Type: Review

References (89)

1. Anderson Jr FA, Wheeler HB, Goldberg RJ, Hosmer DW, Patwardhan NA, Jovanovic B, et al. A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism: the Worcester study. Arch Intern Med 1991;151:933-8.
2. Silverstein MD, Heit JA, Mohr DN, Petterson TM, O'Fallon WM, Melton III LJ. Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med 1998;158:585-93.
3. Nordstrom M, Lindblad B. Autopsy-verified venous thromboembolism within a defined urban population-the city of Malmo, Sweden. APMIS 1998;106:378-84.
4. Dalen JE, Alpert JS. Natural history of pulmonary embolism. Prog Cardiovasc Dis 1975;17:259-70.
5. Dismuke SE. Pulmonary embolism as a cause of death. JAMA 1986;255:2039-42.
6. Carson JL, Kelley MA, Duff A, Weg JG, Fulkerson WJ, Palevsky HI, et al. The clinical course of pulmonary embolism. N Engl J Med 1992;326:1240-5.
7. Alpert JS, Smith R, Carlson CJ, Ockene IS, Dexter L, Dalen JE. Mortality in patients treated for pulmonary embolism. JAMA 1976;236:1477-80.
8. Hirsh J, Bates SM. Prognosis in acute pulmonary embolism. Lancet 1999;353:1375-6.
9. The PIOPED Investigators. Value of the ventilation/perfusion scan in acute pulmonary embolism: results of the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED). JAMA 1990;263:2753-9.
10. Wells PS, Ginsberg JS, Anderson DR, Kearon C, Gent M, Turpie AG, et al. Use of a clinical model for safe management of patients with suspected pulmonary embolism. Ann Intern Med 1998;129:997-1005.
11. Hull RD, Hirsh J, Carter CJ, Jay RM, Dodd PE, Ockelford PA, et al. Pulmonary angiography, ventilation lung scanning, and venography for clinically suspected pulmonary embolism with abnormal perfusion lung scan. Arm Intern Med 1983;98:891-9.
12. Hyers TM, Agnelli G, Hull RD, Morris TA, Samama M, Tapson V, et al. Antithrombotic therapy for venous thromboembolic disease. Chest 2001;119(1 Suppl):176S-93S.
13. Schluger N, Henschke C, King T, Russo R, Binkert B, Rackson M, et al. Diagnosis of pulmonary embolism at a large teaching hospital. J Thorac Imaging 1994;9:180-4.
14. van Beek EJ, Buller HR, Brandjes DP, Rutten GC, ten Cate JW. Diagnosis of clinically suspected pulmonary embolism: a survey of current practice in a teaching hospital. Neth J Med 1994;44:50-5.
15. Egermayer P, Town GI. The mortality of untreated pulmonary embolism in patients with intermediate probability lung scans. Chest 1998;114:1497.
16. Egermayer P, Town GI. The clinical significance of pulmonary embolism: uncertainties and implications for treatment-a debate. J Intern Med 1997;241:5-10.
17. Stein PD, Athanasoulis C, Alavi A, Greenspan RH, Hales CA, Saltzman HA, et al. Complications and validity of pulmonary angiography in acute pulmonary embolism. Circulation 1992;85:462-8.
18. Hudson ER, Smith TP, McDermott VG, Newman GE, Suhocki PV, Payne CS, et al. Pulmonary angiography performed with iopamidol: complications in 1434 patients. Radiology 1996;198:61-5.
19. Wells PS, Ginsberg JS, Anderson DR, Kearon C, Gent M, Weitz J, et al. Utility of ultrasound imaging of the lower extremities in the diagnostic approach in patients with suspected pulmonary embolism. J Intern Med 2001;250:262-4.
20. Turkstra F, Kuijer PMM, van Beek EJR, Brandjes DPM, ten Cate JW, Buller HR. Diagnostic utility of ultrasonography of leg veins in patients suspected of having pulmonary embolism. Ann Intern Med 1997;126:775-81.
21. Wells PS, Anderson DR, Rodger MA, Stiell I, Dreyer JF, Barnes D, et al. Excluding pulmonary embolism at the bedside without diagnostic imaging: management of patients with suspected pulmonary embolism presenting to the emergency department by using a simple clinical model and D-dimer. Ann Intern Med 2001;135:98-107.
22. Remy-Jardin M, Remy J. Spiral CT angiography of the pulmonary circulation. Radiology 1999;212:615-36.
23. Mayo JR, Remy-Jardin M, Muller NL, Remy J, Worsley DF, Hossein-Foucher C, et al. Pulmonary embolism: prospective comparison of spiral CT with ventilation-perfusion scintigraphy. Radiology 1997;205:447-52.
24. Birdwell BG, Raskob GE, Whitsett TL, Durica SS, Comp PC, George JN, et al. Predictive value of compression ultrasonography for deep vein thrombosis in symptomatic outpatients: clinical implications of the site of vein noncompressibility. Arch Intern Med 2000;160:309-13.
25. Shah AA, Davis SD, Gamsu G, Intriere L. Parenchymal and pleural findings in patients with and patients without acute pulmonary embolism detected at spiral CT. Radiology 1999;211:147-53.
26. Rathbun SW, Raskob G, Whitsett TL. Sensitivity and specificity of helical computed tomography in the diagnosis of pulmonary embolism: a systematic review. Ann Intern Med 2000;132:227-32.
27. Mullins MD, Becker DM, Hagspiel KD, Philbrick JT. The role of spiral volumetric computed tomography in the diagnosis of pulmonary embolism. Arch Intern Med 2000;160:293-8.
28. Perrier A, Howarth N, Didier D, Loubeyre P, Unger PF, de Moerloose P, et al. Performance of helical computed tomography in unselected outpatients with suspected pulmonary embolism. Ann Intern Med 2001;135:88-97.
29. Garg K, Welsh CH, Feyerabend AJ, Subber SW, Russ PD, Johnston RJ, et al. Pulmonary embolism: diagnosis with spiral CT and ventilation-perfusion scanning - correlation with pulmonary angiographic results or clinical outcome. Radiology 1998;208:201-8.
30. Cross JL. Spiral CT and ventilation perfusion scintigraphy for the diagnosis of pulmonary embolism - reply. Clin Radiol 1998;53:784.
31. Greaves MS, Hart EM, Aberle DR. CT of pulmonary thromboembolism. Semin Ultrasound CT MR 1997;18:323-37.
32. Goodman LR. Helical CT for initial imaging of pulmonary embolus. AJR Am J Roentgenol 1998;171:1153-4.
33. Goodman LR. CT of acute pulmonary emboli: where does it fit? Radiographics 1997;17:1037-42.
34. Remy-Jardin M, Remy J, Artraud D, Fribourg M, Beregi JP. Spiral CT of pulmonary embolism: diagnostic approach, interpretive pitfalls and current indications. Eur Radiol 1998;8:1376-90.
35. van Erkle AR, van Rossum AB, Bloem JL, Kievit J, Pattynarna PMT. Spiral CT angiography for suspected pulmonary embolism: a cost-effective analysis. Radiology 1996;201:29-36.
36. Chartrand-Lefebvre C, Howarth N, Lucidarme O, Beigelman C, Cluzel P, Mourey-Gerosa I, et al. Contrastenhanced helical CT for pulmonary embolism detection: inter- and intraobserver agreement among radiologists with variable experience. AJR Am J Roentgenol 1999;172:107-12.
37. Stein PD, Saltzman HA, Weg JG. Clinical characteristics of patients with acute pulmonary embolism. Am J Cardiol 1991;68:1723-4.
38. Stein PD, Terrin ML, Hales CA, Palevsky HI, Saltzman HA, Thompson BT, et al. Clinical, laboratory, roentgenographic, and electrocardiographic findings in patients with acute pulmonary embolism and no preexisting cardiac or pulmonary disease. Chest 1991;100:598-603.
39. Susec O, Boudrow D, Kline JA. The clinical features of acute pulmonary embolism in ambulatory patients. Acad Emerg Med 1997;4:891-7.
40. Manganelli D, Palla A, Donnamaria V, Giuntini C. Clinical features of pulmonary embolism: doubts and certainties. Chest 1996;107(1 Suppl):25S-32S.
41. Anderson Jr FA, Wheeler HB. Venous thromboembolism: risk factors and prophylaxis. Clin Chest Med 1995;16:235-51.
42. Hull RD, Raskob G, Carter CJ, Coates G, Gill GJ, Sackett DL, et al. Pulmonary embolism in outpatients with pleuritic chest pain. Arch Intern Med 1988;148:838-44.
43. Stein PD, Dalen JE, McIntyre KM, Sasahara AA, Wenger NK, Willis III PW. The electrocardiogram in acute pulmonary embolism. Prog Cardiovasc Dis 1975;17:247-57.
44. Ferrari E, Imbert A, Chevalier T, Mihoubi A, Morand P, Baudouy M. The ECG in pulmonary embolism: predictive value of negative T waves in precordial leads-80 case reports. Chest 1997;111:537-43.
45. Rodger MA, Makropoulos D, Turek M, Quevillon J, Raymond F, Rasuli P, et al. Diagnostic value of the electrocardiogram in suspected pulmonary embolism. Am J Cardiol 2000;86:807-9.
46. McFarlane MJ, Imperiale TF. Use of the alveolar - arterial oxygen gradient in the diagnosis of pulmonary embolism. Am J Med 1994;96:57-62.
47. Stein PD, Goldhaber SZ, Henry JW. Alveolar-arterial oxygen gradient in the assessment of acute pulmonary embolism. Chest 1995;107:139-43.
48. Stein PD, Goldhaber SZ, Henry JW, Miller AC. Arterial blood gas analysis in the assessment of suspected acute pulmonary embolism. Chest 1996;109:78-81.
49. Rodger MA, Carrier MC, Jones GN, Rasuli P, Raymond F, Djunaedi H, et al. Diagnostic value of arterial blood gas measurement in suspected pulmonary embolism. Am J Respir Crit Care Med 2000;162:2105-8.
50. Perrier A, Desmarais S, Miron MJ, de Moerioose P, Lepage R, Slosman D, et al. Non-invasive diagnosis of venous thromboembolism in outpatients. Lancet 1999;353:190-5.
51. Richardson WS. Where do pretest probabilities come from? ACP J Club 1999;4:68-9.
52. Jackson RE, Rudoni RR, Pascual R. Emergency physician assessment of the pretest probability of pulmonary embolism. Acad Emerg Med 1999;4:891-7.
53. Rosen MP, Sands DZ, Morris J, Drake W, Davis RB. Does a physician's ability to accurately assess the likelihood of pulmonary embolism increase with training? Acad Med 2000;75:1199-205.
54. Wells PS, Anderson DR, Rodger MA, Ginsberg JS, Kearon C, Gent M, et al. Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: increasing the models utility with the SimpliRED D-dimer. Thromb Haemost 2000;83:416-20.
55. Furlong W, Feeny D, Torrance GW, Horsman J. Guide to design and development of health state utility instrumentation. Hamilton, Ontario: McMaster University Centre for Health Economics and Policy Analysis; 1990.
56. Miniati M, Prediletto R, Formichi B, Marini C, DiRicco C, Tonelli L, et al. Accuracy of clinical assessment in the diagnosis of pulmonary embolism. Am J Respir Crit Care Med 1999;159:864-71.
57. Wicki J, Perrier A, Perneger TV, Bounameaux H, Junod AF. Predicting adverse outcome in patients with acute pulmonary embolism: a risk score. Thromb Haemost 2000;84:548-52.
58. Freyburger G, Trillaud H, Labrouche S, Gauthier P, Javorschi S, Grenier N. Rapid ELISA D-dimer testing in the exclusion of venous thromboembolism in hospitalized patients. Clin Appl Thrombosis/Haemostasis 2000;6:77-81.
59. Kovacs MJ, MacKinnon KM, Anderson D, O'Rourke K, Keeney M, Kearon C, et al. A comparison of three rapid D-dimer methods for the diagnosis of venous thromboembolism. Br J Haematol 2001;115:140-4.
60. Ginsberg JS, Wells PS, Kearon C, Anderson DR, Crowther M, Weitz JI, et al. Sensitivity and specificity of a D-dimer in the diagnosis of pulmonary embolism. Ann Intern Med 1998;129:1006-11.
61. Dempfle C-E. Use of D-dimer assays in the diagnosis of venous thrombosis. Semin Thromb Hemost 2000;26:631-41.
62. Freyburger G, Trillaud H, Labrouche S, Gauthier P, Javorschi S, Bernard P, et al. D-dimer strategy in thrombosis exclusion: a gold standard study in 100 patients suspected of deep vein thrombosis or pulmonary embolism. Eight DD methods compared. Thromb Haemost 1998;79:32-7.
63. Brill-Edwards P, Lee A. D-dimer testing in the diagnosis of acute venous thromboembolism. Thromb Haemost 1999;82:688-94.
64. Sijens PE, van Ingen HE, van Beek EJR, Berghout A, Oudkerk M. Rapid ELISA assay for plasma D-dimer in the diagnosis of segmental and subsegmental pulmonary embolism: a comparison with pulmonary angiography. Thromb Haemost 2000;84:156-9.
65. Hoch JR. Management of the complications of long-term venous access. Semin Vasc Surg 1997;10:135-43.
66. Tardy B, Tardy-Poncet B, Viallon A, Lafond P, Page Y, Venet C, et al. Evaluation of D-dimer ELISA test in elderly patients with suspected pulmonary embolism. Thromb Haemost 1998;79:38-41.
67. van der Graaf F, van den BH, van der KM, de Wild PJ, Janssen GW, van Uum SH. Exclusion of deep venous thrombosis with D-dimer testing - comparison of 13 D-dimer methods in 99 outpatients suspected of deep venous thrombosis using venography as reference standard. Thromb Haemost 2000;83:191-8.
68. Owings JT, Gosselin RC, Battistella FD, Anderson JT, Petrich M, Larkin E. Whole blood D-dimer assay: an effective noninvasive method to rule out pulmonary embolism. J Trauma Injury Infect Crit Care 2000;48:795-800.
69. Henry JW, Relyea B, Stein PD. Continuing risk of thromboemboli among patients with normal pulmonary angiograms. Chest 1995;107:1375-8.
70. Hull RD, Raskob GE, Coates G, Panju AA. Clinical validity of a normal perfusion lung scan on patients with suspected pulmonary embolism. Chest 1990;97:23-6.
71. van Beek EJR, Kuyer PMM, Schenk BE, Brandjes DPM, ten Cate JW, Büller HR. A normal perfusion lung scan in patients with clinically suspected pulmonary embolism: frequency and clinical validity. Chest 1995;108:170-3.
72. Kipper MS, Moser KM, Kortman KE, Ashburn WL. Long-term follow-up of patients with suspected pulmonary embolism and a normal lung scan: perfusion scans in embolic suspects. Chest 1982;82:411-5.
73. Hillarp, A, Svensson P, Dahlback B. Prothrombin gene mutation and venous thrombosis in unselected outpatients [abstract]. Thromb Haemost Supplement 1997;OC-1545:378-9.
74. Rock G, Wells PS. New concepts in coagulation. Crit Rev Clin Lab Sci 1997;34:475-501.
75. Gosselin MV, Rubin GD, Leung AN, Huang J, Rizk NW. Unsuspected pulmonary embolism: prospective detection on routine helical CT scans. Radiology 1998;208:209-15.
76. Feinstein AR. "Clinical judgment" revisited: the distraction of quantitative models. Ann Intern Med 1994;120:799-805.
77. Wicki J, Perneger TV, Junod AF, Bounameaux H, Perrier A. Assessing clinical probability of pulmonary embolism in the emergency ward: a simple score. Arch Intern Med 2001;161:92-7.
78. Farmer RDT, Lawrenson RA, Thompson CR, Kennedy JG, Hambleton IR. Population-based study of risk of venous thromboembolism associated with various oral contraceptives. Lancet 1997;349:83-8.
79. Worsley DF, Alavi A. Comprehensive analysis of the results of the PIOPED study: Prospective Investigation of Pulmonary Embolism Diagnosis. J Nucl Med 1995;36:2380-7.
80. Cohen J. Statistical power analysis for the behavioural sciences. 2nd edition. Hillsdale (NJ): Lawrence Erlbaum; 1988.
81. Wells PS, Anderson DR, Burton E. Management of patients with suspected pulmonary embolism (PE) presenting to the emergency department (ED) using clinical probability and D-dimer [abstract]. Blood 1999;94(10 Suppl 1):25.
82. Berghout A, Oudkerk M, Hicks SG, Teng TH, Pillay M, Buller HR. Active implementation of a consensus strategy improves diagnosis and management in suspected pulmonary embolism. Q J Med 2000;93:335-40.
83. Goldstein NM, Kollef MH, Ward S, Gage BF. The impact of the introduction of a rapid D-dimer assay on the diagnostic evaluation of suspected pulmonary embolism. Arch Intern Med 2001;161:567-71.
84. Douketis JD, Kearon C, Bates S, Duku EK, Ginsberg JS. Risk of fatal pulmonary embolism in patients with treated venous thromboembolism. JAMA 1998;279:458-62.
85. Heit J, Silverstein MD, Mohr DN, Petterson TM, O'Fallon WM, Melton III LM. Predictors of survival after deep vein thrombosis and pulmonary embolism. Arch Intern Med 1999;159:445-53.
86. Goldhaber SZ, Visani L, De Rosa M. Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet 1999;353:1386-9.
87. Kasper W, Konstantinides S, Geibel A, Tiede N, Krause T, et al. Prognostic significance of right ventricular afterload stress detected by echocardiography in patients with clinically suspected pulmonary embolism. Heart 1997;77:346-9.
88. Ribeiro A, Lindmarker P, Juhlin-Dannfelt A, Johnsson H, Jorfeldt L. Echocardiography Doppler in pulmonary embolism: right ventricular dysfunction as a predictor of mortality rate. Am Heart J 1997;134:479-87.
89. Giannitsis E, Mueller-Bardorff M, Kurowski V, Weidtmann B, Wiegand U, Kampmann M, et al. Independent prognostic value of cardiac troponin T in patients with confirmed pulmonary embolism. Circulation 2000;102:211-7.