Abstract: . . .  0.36)        Prob post-test 8% V/P scan Normale (LR 0.1)        Prob post-test 2%   Likelihood Ratio   Prob. Pre-test   Prob. Post-test   LR   Fagan et al. Nejm, 293:257, 1975   V/P lung scan nella diagnosi di EP   Risultati nella nostra paziente     Scintigrafia polmonare perfusionale Difetto perfusionale a carico del lobo inferiore del polmone sinistro. Il reperto indicativo di PE con probabilit intermedia   Probabilit pre-test: 20% Probabilit post-test: 25%   Quali tests diagnostici nell Embolia Polmonare   Pulmonary angiography is the gold standard investigation for pulmonary embolism, but it is invasive and associated with 0.5% mortality. Spiral computed tomography scans are more reliable but emboli in small vessels can be missed. A ventilation-perfusion scan using technetium DTPA (ditriaminopentaric acid) is more widely used. However this investigation is non-specific, and is diagnostic in only 30% of cases. Measurement of fibrin D-dimer levels , used for deep vein thrombosis, is helpful, as is compression ultrasound in the detection of occult deep vein thrombosis .   N Engl J Med 2003;349:1247-56.   Rules for predicting the Probability of Pulmonary . . .
. . .    Suspect EP History Clinical Examination   Assess likelihood   Low Clinical Probability of PE   High/Intermediate Clinical Probability of PE   D-Dimer Assay   Normal      High    Spiral CT angiography   V/Q Pulmonary Scan*   Negative   Positive   Equivocal   Compression Ultrasonography   Negative   Positive   No PE   No PE     Treat for PE    Pulm   Angio.   Risultati nella nostra paziente     Scintigrafia polmonare perfusionale Difetto perfusionale a carico del lobo inferiore del polmone sinistro. Il reperto indicativo di PE con probabilit intermedia Doppler Venoso Arti Inferiori TVP a carico del distretto ileo-femorale dellarto destro   Perch importante riconoscere una EP                     Deep vein thrombosis (DVT) occurs in approximately 2 million Americans each year and each year 600,000 of these patients develop pulmonary embolism. Each year as many as 200,000 patients die with pulmonary embolism, and PE is the third most common cause of death in the US and more people die each year from pulmonary . . .
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