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In the era of multislice CT, do we still need leg ultrasonography to diagnose pulmonary embolism?

Nature Clinical Practice Cardiovascular Medicine volume 5, pages 688–689 (2008)Cite this article

Abstract

The results of a multicenter, randomized, prospective, noninferiority trial by Righini et al., together with the low prevalence of a positive CT venography (CTV) scan alone shown by many other investigators, indicate that leg studies after multislice CT angiography for thromboembolism are redundant. The proportion of diagnoses that are made on the basis of a positive CTV scan in patients with a negative multislice CT angiography scan, however, is 14% on average. The diagnostic yield of CTV and of compression ultrasound could be increased by their select use in patients who are likely to have deep-vein thrombosis. Radiation exposure from CTV can be reduced by eliminating imaging of the pelvic veins and by obtaining discontinuous axial images of the proximal leg veins. There are several valid reasons for recommending or not recommending leg studies in patients with suspected pulmonary embolism, and the choice of diagnostic tests should be individualized on a patient-by-patient basis.

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References

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Authors and Affiliations

  1. and a full-time affiliate Professor in the Department of Medicine at Wayne State University, PD Stein is Director of Research Education at St Joseph Mercy Oakland Hospital in Pontiac, MI, Detroit, MI,

    Paul D Stein

  2. LR Goodman is Chief of Thoracic Imaging and Professor of Radiology and Medicine at the Medical College of Wisconsin, Milwaukee, WI,

    Lawrence R Goodman

  3. HD Sostman is Executive Vice President of the Methodist Hospital System, Houston, TX, and Professor of Radiology and Executive Vice Dean at the Weill Cornell Medical College, New York, NY, USA.,

    H Dirk Sostman

Authors
  1. Paul D Stein
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  2. Lawrence R Goodman
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  3. H Dirk Sostman
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Correspondence to Paul D Stein.

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The authors declare no competing financial interests.

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Stein, P., Goodman, L. & Sostman, H. In the era of multislice CT, do we still need leg ultrasonography to diagnose pulmonary embolism?. Nat Rev Cardiol 5, 688–689 (2008). https://doi.org/10.1038/ncpcardio1345

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