April 26, 2009

Suspected Pulmonary Embolism in Pregnant Patient (2)

Potential algorithm for pulmonary embolism diagnosis in pregnant women (adapted from Pahade JK, et al. Radiographics 2009; 10.1148/rg.293085226)

First-Line Imaging Tests
Why Perform Chest Radiography?
  • Search for other causes of symptoms
  • Use to triage for further test, ie to perform lung scintigraphy or CT pulmonary angiography as the next test
  • Normal chest radiograph does not exclude PE
Why Perform Lower Extremity Ultrasound?
  • Positive result can be used to justified anticoagulation without further imaging
  • Negative result should warrant further imaging in the setting of clinically suspected PE because PE may occur in the absence of DVT, isolated pelvic DVT may occur without DVT in lower extremities
  • DVT is more common in the left lower extremity (more than right)

Pahade JK, et al. Imaging pregnant patients with suspected pulmonary embolism: what the radiologist needs to know. Radiographics 2009; 10.1148/rg.293085226 (March 30, 2009)

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