Multiorgan ultrasonography for the diagnosis of pulmonary embolism

Clinical symptoms of pulmonary embolism (PE) are nonspecific and multidetector CT pulmonary angiography (MCTPA) is largely used as a second-line imaging test, exposing patients to high-dose radiation and potential complications. The aim of this study is to investigate the diagnostic value of multiorgan ultrasonography (MOUS): chest (ChUS), heart (EchCG), and leg vein compression ultrasonography (CUS) combined with Wells score and D-dimer. Methods: In a prospective study (02.2017-02.2018) we observed 55 consecutive adults (28 males and 27 females) age x = 56.2 ± SD 14.0 with suspected PE. All patients with Wells score >4 and those with score Results: PE was diagnosed in 42 of 55 enrolled patients (76.4%). ChUS yielded sensitivity (Se) 66% and specificity (Sp) of 77%, EchCG 69% and 92%, and CUS 59% and 100%, respectively. One positive result of MOUS was with accuracy (Acc) 91%, Se 95%, Sp 77% for PE. In patients with ≥2 positive US tests the Acc was 84%, Se 81% and Sp 92%. No patient received PE as a final diagnosis among the MOUS negative patients (n=10, 18%). Conclusions: MOUS is more accurate and sensitive than each one single-organ ultrasonography. In emergency conditions and/or in cases contraindicated for CTPA it could be used as an alternative imaging method for PE diagnosis, safely reducing the MCTPA burden.