Sensitivity and Specificity of Helical Computed Tomography in the Diagnosis of Pulmonary Embolism: A Systematic Review

Article Abstract:

More research is needed to determine whether helical computed tomography (CT) is accurate in detecting pulmonary embolism. Pulmonary embolism occurs when a blood clot forms in the body and travels to the lungs. Researchers found only 15 studies that evaluated helical CT for this purpose and most did not meet their strict criteria for an adequate test of the procedure.

CT imaging, CAT scans

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Low-probability lung scan findings: A need for change

Article Abstract:

Pulmonary embolism, the lodging of a blood clot in the lungs, is a potentially life-threatening condition. The most commonly used screening test for pulmonary embolism is the ventilation-perfusion scan, a nuclear imaging study that evaluates airflow and blood flow to the lung. The two most commonly used classification systems for interpreting lung scans grade the results as normal, of low-, intermediate-, or high-probability of pulmonary embolism. The results of these scans are often used by clinicians in deciding to recommend pulmonary angiography, an invasive means of making a definitive diagnosis of pulmonary embolus. A total of 483 consecutive patients with symptoms of a possible pulmonary embolus, including shortness of breath, chest pain, spitting up blood, and fainting. After lung scans were performed and results were analyzed, some patients who were ultimately diagnosed with pulmonary embolism had low-probability findings on their lung scan (28 out of 120 patients on one test; 36 out of 141 on another test). The term low-probability scan has been somewhat misleading; this finding is occasionally interpreted as negative, but a significant number of patients with pulmonary emboli have low-probability scans. Therefore, it has been proposed that, to improve patient care, ventilation-perfusion scans be reclassified as normal, high-probability, or nondiagnostic. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Pulmonary function tests, Radionuclide imaging, Radioisotope scanning

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The clinical validity of normal compression ultrasonography in outpatients suspected of having deep venous thrombosis

Article Abstract:

Conservative management of patients with suspected deep venous blood clots but normal ultrasounds appears to be safe. Anticoagulation therapy was reserved for patients who either had initially abnormal venous ultrasounds or an abnormal ultrasound five to seven days later, regardless of symptoms. Of the 405 patients managed with this tactic, none of the untreated patients with consistently normal ultrasounds died from a venous blood clot while only 0.6% of these patients later even developed a deep venous blood clot. In comparison, 5.7% of the patients treated after an abnormal ultrasound had a confirmed blood clot.

Care and treatment, Ultrasound imaging, Thrombosis, Deep vein, Deep vein thrombosis

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