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Hamostaseologie 2018; 38(01): 11-21
DOI: 10.5482/HAMO-17-07-0023
Review
Schattauer GmbH

Diagnosis of acute Pulmonary Embolism

Diagnose der akuten Lungenembolie
Marc Righini
1   Division of Angiology and Hemostasis, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland
,
Helia Robert-Ebadi
1   Division of Angiology and Hemostasis, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland
› Author Affiliations
Further Information

Publication History

received: 13 July 2017

accepted in revised form: 05 December 2017

Publication Date:
26 February 2018 (online)

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Summary

During the last three decades, considerable advances in the management of patients with suspected pulmonary embolism (PE) have improved diagnostic accuracy and made management algorithms safer, easier to use and well standardized. These diagnostic algorithms are mainly based on the assessment of clinical pretest probability, D-Dimer measurement and imaging tests, mainly computed tomography pulmonary angiography (CTPA). These diagnostic algorithms allow a safe and cost-effective diagnosis for most patients with suspected PE.

In this review, we discuss current existing evidence for PE diagnosis, the challenge of diagnosing PE in special patient populations, as well as novel imaging tests for PE diagnosis.

Zusammenfassung

In den vergangenen drei Jahrzehnten haben erhebliche Fortschritte bei der Diagnostik von Patienten mit Verdacht auf Lungenembolie (LE) zu einer Verbesserung der Diagnosesicherheit geführt. Dadurch wurden die diagnostischen Algorithmen sicherer und einfacher in der Anwendung und sind mittlerweile zuverlässig standardisiert. Diese diagnostischen Algorithmen beruhen vor allem auf der Beurteilung der klinischen Prä-Test-Wahrscheinlichkeit, der D-Dimer-Messung und bildgebenden Untersuchungen, insbesondere der Computertomografie-Pulmonalangiografie (CTPA). Diese diagnostischen Algorithmen erlauben bei den meisten Patienten mit Verdacht auf LE eine sichere und wirtschaftliche Diagnose.

In dieser Übersicht diskutieren wir die aktuell vorliegende Evidenz für die LE Diagnostik, die Herausforderung einer LE-Diagnose in speziellen Patientenkollektiven sowie neuartige bildgebende Verfahren für die LE-Diagnose.

Keywords

Pulmonary embolism - pre-test clinical probability - D-dimer - age-adjusted D-dimer cutoff - computed tomography pulmonary angiography

Schlüsselwörter

Lungenembolie - klinische Prä-Test-Wahrscheinlichkeit - D-Dimer - altersadjustierter D-Dimer-Schwellenwert - Computertomografie-Pulmonalangiografie
 

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