Purpose: To assess the feasibility and diagnostic performance of lung transthoracic sonography in patients with suspected pulmonary embolism.
Method: In a prospective clinical study we compared sonographic findings of the peripheral lung with various scintigraphic gradings and D-dimer plasma concentrations. One hundred and nineteen consecutive patients with clinical signs of pulmonary embolism were investigated within 24 hours of the onset of symptoms.
Results: Seventy patients with suspected pulmonary embolism (59%) had sonographic lesions, which were echo poor, homogeneous and rounded or wedge-shaped with a hyperechoic reflexion in the centre. Of the patients with high-probability scintigraphic scans 86% had such sonographic lesions as had 79% with intermediate, 64% with low-probability and 33% with normal scintigraphic scans. Of the patients with positive sonographic findings and normal or low-probability scans only a minority (14%) had negative D-dimer tests.
Conclusion: We found a high rate of specific sonographic lesions in patients with suspected pulmonary embolism when investigating the peripheral lung with ultrasound.