Interest of chest X-ray in tailoring the diagnostic strategy in patients with suspected pulmonary embolism. - Université de Bretagne Occidentale Access content directly
Journal Articles Blood Coagulation & Fibrinolysis Year : 2015

Interest of chest X-ray in tailoring the diagnostic strategy in patients with suspected pulmonary embolism.

Abstract

Current diagnostic strategies for pulmonary embolism rely on the sequential use of noninvasive diagnostic tests including ventilation-perfusion (V/Q) scan and computed tomography pulmonary angiography (CTPA). V/Q scan remains criticized because of a high proportion of nondiagnostic test results, especially when the chest X-ray (CXR) is abnormal. The present study assesses whether CXR results have an impact on the conclusiveness of a noninvasive diagnostic strategy of pulmonary embolism based on the combination of pretest probability, compression ultrasonography, V/Q scan, and CTPA. Patients suspected of having pulmonary embolism were managed according to a validated diagnostic strategy. All patients underwent a CXR within 24 h of the suspicion of pulmonary embolism. CXR results were correlated to strategy conclusiveness, as assessed by the rate of required CTPA as per the diagnostic algorithm. Two hundred and twenty-three patients were retrospectively analyzed. CXRs were considered as normal in 108 (48%) patients and abnormal in 115 (52%) patients. According to the diagnostic algorithm, a CTPA was required to reach a diagnostic conclusion in 11 (10%) patients of the normal CXR group, and in 14 (12%) patients of the abnormal CXR group (P > 0.05). In this study, the presence of CXR abnormalities did not have an impact on the conclusiveness of a diagnostic strategy of pulmonary embolism based on V/Q scan. CXR abnormalities should likely not be regarded as a contraindication to the use of V/Q scan in patients with suspected pulmonary embolism.
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Dates and versions

hal-01276246 , version 1 (19-02-2016)

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Philippe Robin, Pierre-Yves Le Roux, Valentin Tissot, Aurélien Delluc, Alexandra Le Duc-Pennec, et al.. Interest of chest X-ray in tailoring the diagnostic strategy in patients with suspected pulmonary embolism.. Blood Coagulation & Fibrinolysis, 2015, 26 (6), pp.643-8. ⟨10.1097/MBC.0000000000000309⟩. ⟨hal-01276246⟩
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