Diagnosis: Imaging Techniques - 05/08/11

Doi : 10.1016/j.ccm.2010.06.002

C. Gregory Elliott, MD ^a,^b,^⁎ , Todd D. Lovelace, MD ^c, Lynette M. Brown, MD, PhD ^a,^b, Daniel Adams, MD ^a
^a Department of Medicine, Intermountain Medical Center, 5121 South Cottonwood Street, Suite 307, Murray, UT 84107, USA
^b Department of Medicine, University of Utah School of Medicine, 30 North 1900 East, Room 4C104, Salt Lake City, UT 84132-2406, USA
^c Department of Radiology, Intermountain Medical Center, 5121 South Cottonwood Street, Suite 307, Murray, UT 84107, USA

Corresponding author. Department of Medicine, Intermountain Medical Center, 5121 South Cottonwood Street, Suite 307, Murray, UT 84107.

Résumé

The diagnosis of venous thromboembolism (VTE) cannot be confirmed or excluded by the medical history and physical examination alone. Objective testing is required in all cases of clinically suspected VTE; for most patients, this includes imaging modalities such as compression ultrasonography, ventilation-perfusion lung scintigraphy, or computed tomography pulmonary angiography (CTPA). Conventional pulmonary arteriography remains useful when CTPA is nondiagnostic or when an intervention such as catheter embolectomy is planned. Although CTPA is important in the evaluation of suspected VTE, ultimately the clinician must balance the risks against the benefits of CTPA for individual patients. Bedside echocardiography may be most appropriate for patients with hypotension or shock and suspected pulmonary embolism.

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Keywords : Deep vein thrombosis, Venous thromboembolism, Pulmonary embolus, Computed tomography, Ultrasonography, Radiation

Plan

Funding: None.

Disclosure: Dr Elliott certifies that he has no relationship including consultation, paid speaking, grant support, equity, patents or royalties from any company that makes products relevant to this manuscript. Dr Lovelace certifies that he has no relationship including consultation, paid speaking, grant support, equity, patents or royalties from any company that makes products relevant to this manuscript. Dr Brown certifies that she has no relationship including consultation, paid speaking, grant support, equity, patents or royalties from any company that makes products relevant to this manuscript. Dr Adams certifies that he has no relationship including consultation, paid speaking, grant support, equity, patents or royalties from any company that makes products relevant to this manuscript.