Giornale italiano di cardiologia
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Comparative Study
Diagnostic approach to acute pulmonary embolism in a general hospital. A two-year analysis.
Several approaches have been proposed for the diagnosis of acute pulmonary embolism (PE), but little is known about the strategies effectively used in daily clinical practice. ⋯ At our institution, where multiple and modern diagnostic facilities are available, ventilation/perfusion lung scanning still represents the most frequently used imaging technique. Spiral CT is employed quite often as an alternative to either lung scintigraphy or pulmonary angiography which, in turn, is used very seldom. Ultrasonography of the lower-limbs is widely utilized (although not in a serial manner and only as a second-line test), while the role of echocardiography appears to be marginal. Spiral CT, pulmonary angiography and lower-limb ultrasonography showed high diagnostic accuracy, while the accuracy of lung scintigraphy and echocardiography was confirmed as being suboptimal. However, due to the retrospective design of our study and the characteristics of our population, these results cannot be extrapolated to pts referred for suspected acute PE, in whom further investigations are thus warranted in order to identify the most cost-effective diagnostic approach.