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Pulmonary embolism: confirmation with venous duplex US as adjunct to lung scanning
1Department of Medical Imaging, Hennepin County Medical Center, Minneapolis, MN 55415.
Purpose:
To assess the prevalence of deep venous thrombosis with venous duplex ultrasonography (US) in patients who underwent radionuclide lung scanning for evaluation of clinically suspected pulmonary embolism (PE) and to assess the clinical usefulness of this type of US in the selection of patients for anticoagulant therapy.
Materials And Methods:
Two hundred eighty-five lung scan and duplex US examinations in 267 consecutive patients seen between January 1987 and June 1990 with clinical evidence of PE (151 men and 134 women, aged 17-98 years [mean, 57 years]) were retrospectively reviewed. Lung scans were divided into four groups: normal, depicting up to 30% probability of PE, indeterminate or intermediate probability of PE, and greater than 90% probability of PE.
Results:
Thrombotic disease was confirmed with US in seven (21%) of 33 patients with normal lung scans and in 64 (25%) of 252 patients with abnormal lung scans.
Conclusion:
Venous duplex Doppler US is a useful adjunct to lung scanning in patients with signs and/or symptoms of PE.