Diagnostic accuracy of focused deep venous, lung, cardiac, and multiorgan ultrasound in suspected pulmonary embolism: a systematic review and meta-analysis

Casper Falster, Niels Jacobsen, Karen Coman, Mikkel Højlund, Thomas Gaist, Stefan Posth, Jacob Møller, Mikkel Brabrand, Christian Laursen

Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review


Background: Suspected pulmonary embolism is a frequent cause of referral to emergency departments. Computed tomography angiography is considered the diagnostic gold standard, but exposes the patient to radiation and is complicated or impossible in cases of severe hemodynamic instability, renal failure or allergy to contrast media.Aims: We aimed to review the existing literature on feasibility of point-of-care ultrasound as a diagnostic alternative.Methods: We conducted a systematic review by searching MEDLINE, Embase, CINAHL, and Cochrane library for studies assessing diagnostic accuracy of deep venous, lung or cardiac ultrasound in suspected pulmonary embolism. Meta-analysis of reported accuracy was performed by construction of hierarchical summary receiver operator curves.Results: Seventy studies on a total of 32 unique ultrasound signs were included. Most notable signs were bilateral compression of femoral and popliteal veins (22 studies; 4,708 patients; sensitivity 0·44 [0·36-0·51]; specificity 0·97 [0·95-0·98]), presence of at least one hypoechoic pleural based lesion (19 studies; 2,134 patients; sensitivity 0·81 [0·73-0·87]; specificity 0·87 [0·81-0·92]), D-sign (13 studies; 1,579 patients; sensitivity 0·30 [0·25-0·35]; specificity 0·96 [0·93-0·98]), visible right ventricular thrombus (5 studies; 995 patients; sensitivity 0·05 [0·03-0·08]; specificity 1·00 [0·99-1·00], and McConnell’s sign (11 studies; 1,480 patients; sensitivity 0·29 [0·20-0·40]; specificity 0·99 [0·97-0·99]).Conclusions: Several ultrasound signs exhibit a high specificity for pulmonary embolism and may improve the selection of patients for radiation imaging.FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, OA4347.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
BogserieEuropean Respiratory Journal. Supplement
Udgave nummersuppl 65
StatusUdgivet - 5. sep. 2021
BegivenhedERS International Congress 2021 -
Varighed: 5. sep. 20218. sep. 2021


KonferenceERS International Congress 2021


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