Objective To investigate the value of different imageology methods in the diagnosis of acute pulmonary thromboembolism (PTE).Methods 22 cases diagnosed acute PTE in the last two years were retrospectively analysed,including 4 cases diagnosed by clinical signs and symptoms who did not perform further examinations due to severity of the disease (2 cases confirmed by autopsy),18 cases diagnosed by either two methods of computed tomographic pulmonary angiography (CTPA),ultrasound,radioisotope scanning of lung and pulmonary arteriography.The diagnostic positive rate of different methods were measured.Results 15 of the 18 subjects were performed CTPA,with a positive rate of 80.0% (12/15).Nuclide detection was performed in 14 cases,in which 5 cases were performed simple pulmonary infusion scanning,9 cases by lung ventilation/perfusion scanning,resulted in a positive rate of 92.9% (13/14).10 cases were performed nuclide phlebography on the low extremity simultaneously,deep phlebothrombosis was found in 5 subjects,and unnormal formation of collateral circulation,blocked blood circulation,stenosis of lumens,and valve disfunction et al were found in other 5 cases.16 cases were performed heart color ultrasound detection,in which 2 were found normal,one was directly found thrombus,and the other 8 cases were found indirect manifestations of acute PTE,including right ventricular enlargement,pulmonary artery hypertension,tricuspid backstreaming et al,with a diagnosing rate of 56% (9/16).Deep phlebothrombosis was found in 6 of the 10 cases who were performed color Doppler ultrasonography on the lower extremity,and one was found with valve function impaired.Conclusions CTPA possesses high positive rate in diagnosing acute PTE with promptness,convenience and reliability,thus can be taken as the front-line detection device.Radioisotope scanning of lung associated with same-time phlebography on the low extremity also has fairly high positive rate to diagnosing acute PTE and make it easy.
Citation: SI Bin,HU ZHENGhong,ZENG Qunli. The value of different imageology methods in the diagnosis of acute pulmonary embolism. Chinese Journal of Respiratory and Critical Care Medicine, 2007, 6(3): 201-204. doi: Copy