When to perform CTA in patients suspected of PE?

Venous thromboembolic disease (VTE) is a common disorder which may be associated with high morbidity or mortality when left untreated. Specific VTE diagnosis is mandatory, as treatment is associated with significant side effects. Therefore, timely diagnostic tests are necessary to establish the pres...

Full description

Saved in:
Bibliographic Details
Published in:European radiology 2008-03, Vol.18 (3), p.500-509
Main Authors: Ghaye, Benoît, Dondelinger, Robert F.
Format: Article
Language:English
Subjects:
Accuracy
Aged
Algorithms
Angiography - economics
Chest
Cost-Benefit Analysis
Diagnostic Radiology
Diagnostic tests
Dyspnea
Electrocardiography
Fibrin Fibrinogen Degradation Products - analysis
Hormone replacement therapy
Humans
Imaging
Internal Medicine
Interventional Radiology
Magnetic Resonance Imaging
Medical imaging
Medicine
Medicine & Public Health
Middle Aged
Mortality
Neuroradiology
Predictive Value of Tests
Pulmonary arteries
Pulmonary Embolism - diagnosis
Pulmonary Embolism - diagnostic imaging
Pulmonary embolisms
Radiology
Risk factors
Sensitivity and Specificity
Surgery
Thromboembolism
Tomography, X-Ray Computed - economics
Ultrasound
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Venous thromboembolic disease (VTE) is a common disorder which may be associated with high morbidity or mortality when left untreated. Specific VTE diagnosis is mandatory, as treatment is associated with significant side effects. Therefore, timely diagnostic tests are necessary to establish the presence or absence of VTE. Computed tomographic pulmonary angiography (CTPA) has reached a high accuracy in the evaluation of pulmonary embolism (PE). Unfortunately, the continuous decrease of the prevalence of PE in the most recent studies can lead to cost-efficacy imbalance and overuse of ionizing radiation when CTPA is used as a single test. Therefore, no single non-invasive test is suitable for all patients and diagnostic strategies based on sequential non-invasive tests are likely to identify patients in whom anticoagulation can be withheld safely and limit the number of patients requiring more invasive or more expensive tests. The cost effectiveness of clinical stratification and D-dimer test has been demonstrated as it reduces the requirement for invasive tests. In this paper, the current role of CTPA in the diagnosis of PE will be reviewed.
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-007-0768-x