A new study of a commonly used imaging test of the chest to detect potentially deadly blood clots in the lung shows that extending the scan to the legs "where the clots typically originate" or adding a standard clinical assessment significantly improves physicians' abilities to accurately diagnose pulmonary embolism. A sudden and potentially deadly blockage in a lung artery, pulmonary embolism affects an estimated 600,000 Americans each year, making it the fourth most commonly occurring cardiovascular problem in the United States. The multicenter study was funded by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH).
The Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) II is the largest study ever conducted to assess the role of contrast-enhanced multidetector computed tomographic (CT) angiography for diagnosing pulmonary embolism. In the June 1, 2006, issue of the New England Journal of Medicine, PIOPED researchers from eight clinical centers report that chest CT angiography alone detects suspected pulmonary embolism in only 83 percent of patients; in contrast, combined results of the chest CT angiogram and the leg CT scan detect clots in 90 percent of patients. The researchers recommend that physicians consider additional test results before ruling out pulmonary embolism in patients whose scan does not detect clots but whose clinical assessment suggests a high likelihood of pulmonary embolism.
"Imaging technologies are one of the most rapidly evolving areas of medicine, and they greatly expand our ability to diagnose and treat disease," said Elias A. Zerhouni, MD, NIH Director and a board-certified radiologist. "In recent years, chest CT scans have become the most widely used technique for diagnosing pulmonary embolism. But, until now, we have not had enough scientific evidence to really understand how accurate they are for detecting this often-fatal condition."
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Contact: NHLBI Communications Office
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NIH/National Heart, Lung, and Blood Institute
31-May-2006
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