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Triage for suspected acute Pulmonary Embolism: Think before opening Pandora's Box.

Abstract：

:This is a review of the current strengths and weaknesses of the various imaging modalities available for the diagnosis of suspected non-massive Pulmonary Embolism (PE). Without careful consideration for the clinical presentation, and the timely application of clinical decision support (CDS) methodology, the current overutilization of imaging resources for this disease will continue. For a patient with a low clinical risk profile and a negative D-dimer there is no reason to consider further workup with imaging; as the negative predictive value in this scenario is the same as imaging. While the current efficacy and effectiveness data support the continued use of Computed Tomographic angiography (CTA) as the imaging golden standard for the diagnosis of PE; this test does have the unintended consequences of radiation exposure, possible overdiagnosis and overuse. There is a persistent lack of appreciation on the part of ordering physicians for the effectiveness of the alternatives to CTA (ventilation-perfusion imaging and contrast enhanced magnetic resonance angiography) in these patients. Careful use of standardized protocols for patient triage and the application of CDS will allow for a better use of imaging resources.

journal_name

Eur J Radiol

journal_title

European journal of radiology

authors

Levin D,Seo JB,Kiely DG,Hatabu H,Gefter W,van Beek EJ,Schiebler ML,2013 International Workshop for Pulmonary Functional Imaging (IWPFI).

doi

10.1016/j.ejrad.2015.03.023

subject

Has Abstract

pub_date

2015-06-01 00:00:00

pages

1202-11

issue

6

eissn

0720-048X

issn

1872-7727

pii

S0720-048X(15)00145-X

journal_volume

84

pub_type

杂志文章,评审

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