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Current Respiratory Medicine Reviews

Editor-in-Chief

ISSN (Print): 1573-398X
ISSN (Online): 1875-6387

Research Article

Echopulmonography as a Surrogate Modality in Disclosure of Occult Pulmonary Consequences of Pulmonary Vascular Occlusion

Author(s): Ahmed Mohammed Abumossalam, Marwa Mohammed Nashat El Mekkawy, Raed Elmetwally Ali Eid, Mohamed Salah and Ahmed Ehab*

Volume 16, Issue 4, 2020

Page: [220 - 227] Pages: 8

DOI: 10.2174/1573398X17666210129123946

Price: $65

Abstract

Background: Diagnostic modalities of pulmonary embolism (PE) are still emerging day after day with new tools and promising characteristic features.

Objective: The aim of our work was to assess the diagnostic yield of echopulmonography in patients with PE regarding pleural, parenchymal and vascular features of acute events and consequences.

Methods: This is a prospective quasi-experimental study in which transthoracic echopulmonography was adopted as a screening method for patients with clinical suspicion of PE in comparison to Multi-Detector Computed Tomography Angiography of the chest, which is the best standard. This study was conducted on 32 patients at the chest department in Mansoura University Hospital and a Specialized Internal Medicine Hospital.

Results: Echopulmonography was positive for pulmonary embolism at 68.75% but was of negative value in 31.25%. On the other hand, CTPA was positive for pulmonary embolism in (71.78%) but was of negative value in 28.12%. EPG confirm PE in 87% of patients diagnosed with PE by CTPA with a false-negative result of 13%. EPG could exclude PE in 77.7% of patients who were negative for PE by CTPA with a false-positive result of 22.2%.

Conclusion: Echopulmonography might show promising features to be a substitute for computed tomography angiography in the diagnosis of pulmonary embolism.

Keywords: Echopulmonography, computed tomography, pulmonary embolism, deep vein thrombosis, DVT, CTPA.

Graphical Abstract
[1]
Bĕlohlávek J, Dytrych V, Linhart A. Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism. Exp Clin Cardiol 2013; 18(2): 129-38.
[PMID: 23940438]
[2]
Torbicki A, et al. Guidelines on diagnosis and management of acute pulmonary embolism. European Heart Journal 21(16): 1301-36.
[3]
Mathis G, Blank W, Reissig A, et al. Thoracic ultrasound for diagnosing pulmonary embolism: a prospective multicenter study of 352 patients. Chest 2005; 128(3): 1531-8.
[http://dx.doi.org/10.1378/chest.128.3.1531] [PMID: 16162754]
[4]
Patel S, Kazerooni EA, Cascade PN. Pulmonary embolism: optimization of small pulmonary artery visualization at multi-detector row CT. Radiology 2003; 227(2): 455-60.
[http://dx.doi.org/10.1148/radiol.2272011139] [PMID: 12732699]
[5]
Janata K, Holzer M, Domanovits H, et al. Mortality of patients with pulmonary embolism. Wien Klin Wochenschr 2002; 114(17-18): 766-72.
[PMID: 12416281]
[6]
Lichtenstein D A, Loubières Y, Reissig A, Kroegel C. Lung sonography in pulmonary embolism. Chest 123(6): 2154-5.
[http://dx.doi.org/10.1378/chest.123.6.2154]
[7]
Comert SS, Caglayan B, Akturk U, et al. The role of thoracic ultrasonography in the diagnosis of pulmonary embolism. Ann Thorac Med 2013; 8(2): 99-104.
[http://dx.doi.org/10.4103/1817-1737.109822] [PMID: 23741272]
[8]
Ceriani E, Combescure C, Le Gal G, et al. Clinical prediction rules for pulmonary embolism: a systematic review and meta-analysis. J Thromb Haemost 2010; 8(5): 957-70.
[http://dx.doi.org/10.1111/j.1538-7836.2010.03801.x] [PMID: 20149072]
[9]
Hoang JK, Lee WK, Hennessy OF. Multidetector CT pulmonary angiography features of pulmonary embolus. J Med Imaging Radiat Oncol 2008; 52(4): 307-17.
[http://dx.doi.org/10.1111/j.1440-1673.2008.01961.x] [PMID: 18811753]
[10]
Reissig A, Kroegel C. Transthoracic ultrasound of lung and pleura in the diagnosis of pulmonary embolism: a novel non-invasive bedside approach. Respiration 2003; 70(5): 441-52.
[http://dx.doi.org/10.1159/000074195] [PMID: 14665764]
[11]
Ouechtati W, Baccar H, Antit S, Bezdeh L, Sidhom S. 323: Pulmonary embolism: the value of transthoracic echocardiography. Arch Cardiovasc Dis Suppl 2013; 5(1): 109.
[http://dx.doi.org/10.1016/S1878-6480(13)71254-0]
[12]
Dresden S, Mitchell P, Rahimi L, et al. Right ventricular dilatation on bedside echocardiography performed by emergency physicians aids in the diagnosis of pulmonary embolism. Ann Emerg Med 2014; 63(1): 16-24.
[http://dx.doi.org/10.1016/j.annemergmed.2013.08.016] [PMID: 24075286]
[13]
Heit JA. The epidemiology of venous thromboembolism in the community. Arterioscler Thromb Vasc Biol 2008; 28(3): 370-2.
[http://dx.doi.org/10.1161/ATVBAHA.108.162545]
[14]
Silverstein MD, Heit JA, Mohr DN, Petterson TM, O’Fallon WM, Melton LJ III. Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med 1998; 158(6): 585-93.
[http://dx.doi.org/10.1001/archinte.158.6.585] [PMID: 9521222]
[15]
Miniati M, Prediletto R, Formichi B, et al. Accuracy of clinical assessment in the diagnosis of pulmonary embolism. Am J Respir Crit Care Med 1999; 159(3): 864-71.
[http://dx.doi.org/10.1164/ajrccm.159.3.9806130] [PMID: 10051264]
[16]
Tapson VF. Acute pulmonary embolism. N Engl J Med 2008; 358(10): 1037-52.
[http://dx.doi.org/10.1056/NEJMra072753] [PMID: 18322285]
[17]
Casazza F, Becattini C, Bongarzoni A, et al. Clinical features and short term outcomes of patients with acute pulmonary embolism. The Italian Pulmonary Embolism Registry (IPER). Thromb Res 2012; 130(6): 847-52.
[http://dx.doi.org/10.1016/j.thromres.2012.08.292] [PMID: 22921592]
[18]
Girard P, Musset D, Parent F, Maitre S, Phlippoteau C, Simonneau G. High prevalence of detectable deep venous thrombosis in patients with acute pulmonary embolism. Chest 1999; 116(4): 903-8.
[http://dx.doi.org/10.1378/chest.116.4.903] [PMID: 10531151]
[19]
Systematic screening of of pulmonary embolism with spiral CT scanner in patients with proximal deep vein thrombosis. Presse Med 1999; 28(12): 633.
[20]
Goldhaber SZ, Bounameaux H. Pulmonary embolism and deep vein thrombosis. Lancet 2012; 379(9828): 1835-46.
[http://dx.doi.org/10.1016/S0140-6736(11)61904-1] [PMID: 22494827]
[21]
Remy-Jardin M, Remy J, Deschildre F, et al. Diagnosis of pulmonary embolism with spiral CT: comparison with pulmonary angiography and scintigraphy. Radiology 1996; 200(3): 699-706.
[http://dx.doi.org/10.1148/radiology.200.3.8756918] [PMID: 8756918]
[22]
Kasper W, Meinertz T, Henkel B, et al. Echocardiographic findings in patients with proved pulmonary embolism. Am Heart J 1986; 112(6): 1284-90.
[http://dx.doi.org/10.1016/0002-8703(86)90361-3] [PMID: 3788776]
[23]
Elhafez S, Shehata M, Rashed M, Ali RE, Mosallam AMA. Echopulmonography versus computed tomographic chest predictors for differentiation between benign and malignant peripheral pulmonary and pleural lesions. Egypt J Chest Dis Tuberc 2013; 62(1): 127-35.
[http://dx.doi.org/10.1016/j.ejcdt.2013.03.003]
[24]
Reissig A, Heyne JP, Kroegel C. Sonography of lung and pleura in pulmonary embolism: sonomorphologic characterization and comparison with spiral CT scanning. Chest 2001; 120(6): 1977-83.
[http://dx.doi.org/10.1378/chest.120.6.1977] [PMID: 11742931]

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