New diagnostic tests for pulmonary embolism

Jeffrey A. Kline, Kathryn L. Johns, Stephen A. Colucciello, Elizabeth G. Israel

Research output: Contribution to journalReview article

79 Scopus citations

Abstract

In 1990, the multicenter Prospective Investigation of Pulmonary Embolism Diagnosis (P OPED), sponsored by the National Institutes of Health, compared the diagnostic value of the radioisotopic ventilation-perfusion lung scan (V/Q scan) with that of pulmonary angiography for the diagnosis of pulmonary embolism (PE). Despite the endurance of the radioisotopic V/Q scan as the most wide y used test for evaluation of pulmonary embolism (PE), a better screening tool is clearly needed for use in the emergency department. During the past decade, several new modalities have emerged for evaluation of patients with suspected PE. We evaluate the diagnostic utility of the D-dimer test and the alveolar dead space determination as potential screening tests and of spiral computed tomography, magnetic resonance imaging, transthoracic echocardiography, and transesophageal echoeardiography as potential confirmatory tests for PE. For comparison, recent data on the diagnostic utility of the alveolar-arterial oxygen gradient and the V/Q scan are included. The potential application of these new tests to a hypothetical ED population is described.

Original languageEnglish (US)
Pages (from-to)168-180
Number of pages13
JournalAnnals of emergency medicine
Volume35
Issue number2
DOIs
StatePublished - Jan 1 2000

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ASJC Scopus subject areas

  • Emergency Medicine

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