| Autor: |
Hull, Russell D., Hirsh, Jack, Carter, Cedric J., Raskob, Gary E., GilI, Gerald J., Jay, Richard M., Leclerc, Jacques R., David, Michelle, Coates, Geoffrey |
| Zdroj: |
Chest; December 1985, Vol. 88 Issue: 6 p819-828, 10p |
| Abstrakt: |
Differing opinions about the value of ventilation-perfusion lung scanning have created controversy concerning the correct approach to the diagnosis of pulmonary embolism. In a prospective study of 305 consecutive patients with clinically suspected pulmonary embolism and abnormal perfusion lung scans, we evaluated the role of ventilation-perfusion lung scanning, pulmonary angiography, and objective testing for venous thrombosis in the diagnostic process. Segmental or greater perfusion defects with ventilation mismatch have a high probability (86 percent) of pulmonary embolism. Contrary to current clinical practice, however, the approach of ruling against pulmonary embolism by a “low probability” scan pattern is incorrect, even with an improved technique for ventilation imaging; the frequency of pulmonary embolism in these patients ranged from 25 to 40 percent. Objective testing for venous thrombosis provides a practical alternative to performing pulmonary angiography in the diagnostic work-up; by providing an endpoint for commencing anticoagulant therapy, a positive result obviates the need for further testing in 20 to 30 percent of patients. |
| Databáze: |
Supplemental Index |
| Externí odkaz: |
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