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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Article dans une revue
Blood Coagulation and Fibrinolysis, Lippincott, Williams & Wilkins, 2015, 26 (6), pp.643-8. 〈10.1097/MBC.0000000000000309〉
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http://hal.univ-brest.fr/hal-01276246
Contributeur : Ghislaine Calvez <>
Soumis le : vendredi 19 février 2016 - 09:35:43
Dernière modification le : mercredi 10 janvier 2018 - 14:42:02

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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 and Fibrinolysis, Lippincott, Williams & Wilkins, 2015, 26 (6), pp.643-8. 〈10.1097/MBC.0000000000000309〉. 〈hal-01276246〉

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