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Pulmonary embolism: accuracy and safety of a negative CT pulmonary angiogram and value of a negative D-dimer assay to exclude CT pulmonary angiogram-detectable pulmonary embolism.

Publication ,  Conference
Subramaniam, RM; Chou, T; Swarbrick, M; Karalus, N
Published in: Australas Radiol
October 2006

This is a retrospective study to determine the accuracy and safety of a negative CT pulmonary angiogram (CTPA) based on clinical outcome and to determine the usefulness of a negative D-dimer assay before CTPA. A total of 483 patients with a negative CTPA study were followed up for 3 months, with the aim of detecting episodes of venous thromboembolism and mortality. Three hundred and forty-nine patients had an immunochromatographic D-dimer assay called 'Simplify', carried out before a CTPA examination. Seventy-eight patients had a negative D-dimer assay and a negative CTPA. Three patients had a negative D-dimer assay and a positive CTPA. All three patients had a moderate pretest clinical probability. Of the 483 patients who had a negative CTPA and a 3-month follow up, 444 (92%) were alive and 39 (8%) had died. Of the 444 patients who were alive, none had any further suspected episode of thromboembolism or had received anticoagulation therapy within the follow-up period. Of those who died, none of the deaths was thought to be as a result of pulmonary embolism (PE). Single-detector helical CT can be used safely as the primary diagnostic test to evaluate PE. Negative Simplify D-dimer assay and low pretest clinical probability exclude CTPA-detectable PE, and a CTPA is unnecessary in this cohort of patients.

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Published In

Australas Radiol

DOI

ISSN

0004-8461

Publication Date

October 2006

Volume

50

Issue

5

Start / End Page

424 / 428

Location

Australia

Related Subject Headings

  • Tomography, Spiral Computed
  • Retrospective Studies
  • Reproducibility of Results
  • Pulmonary Embolism
  • Pulmonary Artery
  • Predictive Value of Tests
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Humans
 

Citation

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Subramaniam, R. M., Chou, T., Swarbrick, M., & Karalus, N. (2006). Pulmonary embolism: accuracy and safety of a negative CT pulmonary angiogram and value of a negative D-dimer assay to exclude CT pulmonary angiogram-detectable pulmonary embolism. In Australas Radiol (Vol. 50, pp. 424–428). Australia. https://doi.org/10.1111/j.1440-1673.2006.01595.x
Subramaniam, R. M., T. Chou, M. Swarbrick, and N. Karalus. “Pulmonary embolism: accuracy and safety of a negative CT pulmonary angiogram and value of a negative D-dimer assay to exclude CT pulmonary angiogram-detectable pulmonary embolism.” In Australas Radiol, 50:424–28, 2006. https://doi.org/10.1111/j.1440-1673.2006.01595.x.
Subramaniam, R. M., et al. “Pulmonary embolism: accuracy and safety of a negative CT pulmonary angiogram and value of a negative D-dimer assay to exclude CT pulmonary angiogram-detectable pulmonary embolism.Australas Radiol, vol. 50, no. 5, 2006, pp. 424–28. Pubmed, doi:10.1111/j.1440-1673.2006.01595.x.
Journal cover image

Published In

Australas Radiol

DOI

ISSN

0004-8461

Publication Date

October 2006

Volume

50

Issue

5

Start / End Page

424 / 428

Location

Australia

Related Subject Headings

  • Tomography, Spiral Computed
  • Retrospective Studies
  • Reproducibility of Results
  • Pulmonary Embolism
  • Pulmonary Artery
  • Predictive Value of Tests
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Humans