Pulmonary embolism compression ultrasonography: Difference between revisions

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{{SK}} Doppler study of the legs, lower extremity noninvasive studies (LENIS)


Compression ultrasound of the lower extremities is not a [[sensitivity (tests)|sensitive]] test for a PE, but can help with diagnosis and with a subsequent treatment plan.
'''Editor(s)-In-Chief:''' {{ATI}}, [[C. Michael Gibson, M.S., M.D.]] [mailto:charlesmichaelgibson@gmail.com]


*''[[medical ultrasound|Compression Ultrasonography]] '', also known as a doppler of the legs is used to evaluate for a [[deep venous thrombosis]] (DVT) of the lower extremities, which can lead to the development of a pulmonary embolism. The presence of a [[deep venous thrombosis|DVT]] shown by [[ultrasonography]] is enough to warrant anticoagulation without requiring further V/Q or spiral CT scans. This is due to the strong association between DVT and PE. Using compression ultrasonography may also be a preferred method of evaluation during [[pregnancy]], in which the other modalities would increase the risk of birth defects due to radiation exposure. A negative doppler scan does not rule out a pulmonary embolism, and low-radiation dose scanning may be required for a pregnant patient to further evaluate for PE.
==Overview==
''
[[Compression ultrasonography]] of the legs is used to evaluate the presence of [[deep venous thrombosis]] (DVT) in the lower extremities, which can lead to the development of a pulmonary embolism (PE). The presence of a [[deep venous thrombosis|DVT]] demonstrated by [[ultrasonography]] is enough to warrant [[anticoagulation]] without a V/Q or spiral [[CT scan]]s. The decision to administer [[anticoagulation]] therapy to a patient with a positive compression ultrasound is due to the strong association between [[DVT]] and subsequent PE. Compression ultrasonography is not the routine initial method of evaluation in a suspected PE during [[pregnancy]] unless the patient has coexisting symptoms and [[signs]] of [[DVT]].<ref name="pmid22086989">{{cite journal| author=Leung AN, Bull TM, Jaeschke R, Lockwood CJ, Boiselle PM, Hurwitz LM et al.| title=An official American Thoracic Society/Society of Thoracic Radiology clinical practice guideline: evaluation of suspected pulmonary embolism in pregnancy. | journal=Am J Respir Crit Care Med | year= 2011 | volume= 184 | issue= 10 | pages= 1200-8 | pmid=22086989 | doi=10.1164/rccm.201108-1575ST | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22086989  }} </ref>  In case the compression ultrasound is negative for [[DVT]] and there is persistent clinical suspicion of PE, the negative ultrasound does not rule out PE and additional imaging tests are required.<ref name="pmid22086989">{{cite journal| author=Leung AN, Bull TM, Jaeschke R, Lockwood CJ, Boiselle PM, Hurwitz LM et al.| title=An official American Thoracic Society/Society of Thoracic Radiology clinical practice guideline: evaluation of suspected pulmonary embolism in pregnancy. | journal=Am J Respir Crit Care Med | year= 2011 | volume= 184 | issue= 10 | pages= 1200-8 | pmid=22086989 | doi=10.1164/rccm.201108-1575ST | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22086989  }} </ref>


==References==
==References==
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{{Reflist|2}}
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[[Category:Pulmonology]]
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Latest revision as of 23:53, 29 July 2020



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Synonyms and keywords: Doppler study of the legs, lower extremity noninvasive studies (LENIS)

Editor(s)-In-Chief: The APEX Trial Investigators, C. Michael Gibson, M.S., M.D. [1]

Overview

Compression ultrasonography of the legs is used to evaluate the presence of deep venous thrombosis (DVT) in the lower extremities, which can lead to the development of a pulmonary embolism (PE). The presence of a DVT demonstrated by ultrasonography is enough to warrant anticoagulation without a V/Q or spiral CT scans. The decision to administer anticoagulation therapy to a patient with a positive compression ultrasound is due to the strong association between DVT and subsequent PE. Compression ultrasonography is not the routine initial method of evaluation in a suspected PE during pregnancy unless the patient has coexisting symptoms and signs of DVT.[1] In case the compression ultrasound is negative for DVT and there is persistent clinical suspicion of PE, the negative ultrasound does not rule out PE and additional imaging tests are required.[1]

References

  1. 1.0 1.1 Leung AN, Bull TM, Jaeschke R, Lockwood CJ, Boiselle PM, Hurwitz LM; et al. (2011). "An official American Thoracic Society/Society of Thoracic Radiology clinical practice guideline: evaluation of suspected pulmonary embolism in pregnancy". Am J Respir Crit Care Med. 184 (10): 1200–8. doi:10.1164/rccm.201108-1575ST. PMID 22086989.

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