Diagnostic value of echocardiography combined with lower-limb venous ultrasonography in pulmonary thromboembolism / 中华超声影像学杂志

ABSTRACT

Objective To evaluate the diagnostic value of deep venous thrombosis(DVT)on lowerlimb venous ultrasonography combined with right ventricular dysfunction (RVD) on transthoracic echocardiography(TTE) in patients with acute pulmonary thrombo embolism(PTE). Methods This prospective multicenter control trial included 520 patients with confirmed acute PTE from 41 hospitals between June 2002 and February 2005.Results The incidence of RVD and DVT was associated with the severity of PTE.There were 57.0%(207/363)patients with RVD,49.6%(1 80/363)patients with DVT,265(73.0%)patients with RVD and/or DVT,and 121(33.3%)patients with combined sign of DVT plus RVD in the whole population.As to major PTE population,206(99.5%)patients had RVD and 121 (58.5%)patients had DVT.In addition,the rate of RVD was much greater in proximal PTE than in lobar PTE and segmental PTE(78.7%,51.4%and 21.7%,respectively,P＜0.001).DVT occurred more frequently in proximal PTE than in lobar PTE and segmental PTE(61.7%,46.8%and 37.0%,respectively,P＜O.001).The incidence of the combined sign was 51.1%,24.3%and 8.7%,respenctively (P＜0.001).Conclusions The incidence of the combined sign of RVD plus DVT was associated with the severity of PTE and the localization of emboli.The combined sign of RVD plus DVT help diagnose major PTE especially in emergency department.