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Related Experiment Video

Updated: Jun 7, 2026

A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis

A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis

Published on: June 2, 2015

[When D-dimers within normal limits do not equate to normal D-dimers].

L Garchery¹, S Motamed, J-M Gaspoz

¹Service de médecine de premier recours, Département de médecine communautaire et de premier recours HUG, 1211 Genève 14. Lucile.Garchery@hcuge.ch

Revue Medicale Suisse

|October 23, 2010

Summary

Diagnosing pulmonary embolism can be challenging due to non-specific symptoms. This study explores strategies when D-dimer tests are normal despite a high clinical suspicion for pulmonary embolism.

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A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis

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Experimental and Imaging Techniques for Examining Fibrin Clot Structures in Normal and Diseased States

Experimental and Imaging Techniques for Examining Fibrin Clot Structures in Normal and Diseased States

Published on: April 1, 2015

Area of Science:

Medical Diagnostics
Cardiology
Pulmonology

Background:

Pulmonary embolism (PE) diagnosis is often complicated by nonspecific clinical presentations.
Accurate and timely diagnosis of PE is crucial due to available effective treatments and potential fatality.
Clinical decision rules and scoring systems aid diagnosis but cannot replace clinical judgment.

Purpose of the Study:

To investigate diagnostic approaches for pulmonary embolism (PE) in patients with normal D-dimer levels but high clinical suspicion.
To address the challenge of missed PE diagnoses when standard laboratory markers are incongruent with clinical presentation.

Main Methods:

Review of diagnostic algorithms for pulmonary embolism.
Analysis of clinical scenarios where D-dimer results contradict clinical suspicion.
Evaluation of alternative diagnostic strategies beyond D-dimer testing.

Main Results:

Normal D-dimer levels can be observed in patients with confirmed pulmonary embolism.
Clinical gestalt and risk stratification scores remain vital in guiding further diagnostic steps.
Imaging modalities like CT pulmonary angiography are essential when clinical suspicion is high despite negative D-dimer.

Conclusions:

Clinical suspicion should guide the diagnostic pathway for pulmonary embolism, even with normal D-dimer results.
A normal D-dimer does not exclude pulmonary embolism in high-risk patients.
Integrating clinical judgment with appropriate imaging is key to avoiding missed pulmonary embolism diagnoses.