Abstract
The aim of the study was to compare transthoracic sonography (TS) with multislice computed tomography (MSCT) in the detection of peripheral pulmonary embolism (PE). In addition, the study verified peripheral parenchymal findings visualized by TS and MSCT. A total of 33 patients (16 females, 17 males; mean age = 65.4 years) with symptoms of suspected PE were enrolled in the study. TS and MSCT were undertaken within 24 h of the beginning of clinical PE signs. Ten patients suffered from PE as visualized by MSCT. The sensitivity of TS for detecting PE was 70.0% and the specificity was 69.6%. Preferentially, PE and peripheral parenchymal findings were situated in the lower lobes. Oligemia was the main parenchymal alteration detected by MSCT. TS demonstrated that wedge-shaped consolidations were frequently associated with PE. In addition, localized pleural effusion was a typical finding in the presence of PE for both TS and MSCT. TS had moderate sensitivity and specificity compared with MSCT. Furthermore, the study revealed that PE is often associated with peripheral parenchymal changes, both of which are detectable by TS and MSCT. In case of contraindication with MSCT, TS is a potential technique for diagnosing PE-related parenchymal findings and can serve as an alternative method in the diagnosis of PE. However, a negative result with TS does not rule out a PE.
Similar content being viewed by others
Abbreviations
- CT:
-
Computed tomography
- MSCT:
-
Multislice computed tomography
- PE:
-
Pulmonary embolism
- TS:
-
Transthoracic sonography
References
Reissig A, Heyne JP, Kroegel C (2004) Ancillary lung parenchymal findings at spiral CT scanning in pulmonary embolism. Relationship to chest sonography. Eur J Radiol 49:250–257
Silverstein MD, Heit JA, Mohr DN, Petterson TM, O’Fallon WM, Melton LJ III (1998) Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med 158:585–593
Anderson FA Jr, Wheeler HB, Goldberg RJ, Hosmer DW, Patwardhan NA, Jovanovic B, Forcier A, Dalen JE (1991) A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism. The Worcester DVT Study. Arch Intern Med 151:933–938
Horlander KT, Mannino DM, Leeper KV (2003) Pulmonary embolism mortality in the United States, 1979–1998: an analysis using multiple-cause mortality data. Arch Intern Med 163:1711–1717
Goldhaber SZ, Visani L, De Rosa M (1999) Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet 353:1386–1389
Shah AA, Davis SD, Gamsu G, Intriere L (1999) Parenchymal and pleural findings in patients with and patients without acute pulmonary embolism detected at spiral CT. Radiology 211:147–153
Coche EE, Muller NL, Kim KI, Wiggs BR, Mayo JR (1998) Acute pulmonary embolism: ancillary findings at spiral CT. Radiology 207:753–758
Reissig A, Heyne JP, Kroegel C (2000) Diagnosis of pulmonary embolism by transthoracic sonography. Sono-morphologic characterization of pulmonary lesions and comparison with spiral computed tomography. Dtsch Med Wochenschr 125:1487–1491
Reissig A, Heyne JP, Kroegel C (2001) Sonography of lung and pleura in pulmonary embolism: sonomorphologic characterization and comparison with spiral CT scanning. Chest 120:1977–1983
Mathis G, Blank W, Reissig A, Lechleitner P, Reuss J, Schuler A, Beckh S (2005) Thoracic ultrasound for diagnosing pulmonary embolism: a prospective multicenter study of 352 patients. Chest 128:1531–1538
Anderson DR, Kahn SR, Rodger MA, Kovacs MJ, Morris T, Hirsch A, Lang E, Stiell I, Kovacs G, Dreyer J, Dennie C, Cartier Y, Barnes D, Burton E, Pleasance S, Skedgel C, O’Rouke K, Wells PS (2007) Computed tomographic pulmonary angiography vs ventilation-perfusion lung scanning in patients with suspected pulmonary embolism: a randomized controlled trial. JAMA 298:2743–2753
Goodman LR, Curtin JJ, Mewissen MW, Foley WD, Lipchik RJ, Crain MR, Sagar KB, Collier BD (1995) Detection of pulmonary embolism in patients with unresolved clinical and scintigraphic diagnosis: helical CT versus angiography. AJR Am J Roentgenol 164:1369–1374
Oser RF, Zuckerman DA, Gutierrez FR, Brink JA (1996) Anatomic distribution of pulmonary emboli at pulmonary angiography: implications for cross-sectional imaging. Radiology 199:31–35
Dawson P, Lees WR (2001) Multi-slice technology in computed tomography. Clin Radiol 56:302–309
Raptopoulos V, Boiselle PM (2001) Multi-detector row spiral CT pulmonary angiography: comparison with single-detector row spiral CT. Radiology 221:606–613
Kroegel C, Reissig A (2003) Principal mechanisms underlying venous thromboembolism: epidemiology, risk factors, pathophysiology and pathogenesis. Respiration 70:7–30
Corrin B (2000) Pathology of the lungs. Churchill Livingstone, London, pp 365–369
Ghaye B, Szapiro D, Mastora I, Delannoy V, Duhamel A, Remy J, Remy-Jardin M (2001) Peripheral pulmonary arteries: how far in the lung does multi-detector row spiral CT allow analysis? Radiology 219:629–636
Gryminski J, Krakowka P, Lypacewicz G (1976) The diagnosis of pleural effusion by ultrasonic and radiologic techniques. Chest 70:33–37
Chintapalli K, Thorsen MK, Olson DL, Goodman LR, Gurney J (1988) Computed tomography of pulmonary thromboembolism and infarction. J Comput Assist Tomogr 12:553–559
Sinner WN (1978) Computed tomographic patterns of pulmonary thromboembolism and infarction. J Comput Assist Tomogr 2:395–399
Balakrishnan J, Meziane MA, Siegelman SS, Fishman EK (1989) Pulmonary infarction: CT appearance with pathologic correlation. J Comput Assist Tomogr 13:941–945
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Pfeil, A., Reissig, A., Heyne, JP. et al. Transthoracic Sonography in Comparison to Multislice Computed Tomography in Detection of Peripheral Pulmonary Embolism. Lung 188, 43–50 (2010). https://doi.org/10.1007/s00408-009-9195-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00408-009-9195-x