Retrospective analysis of the incidence of pulmonary embolism in CT images in patients with a positive value of D-dimers
Authors:
Vlastimil Válek jr.; Vlastimil Válek; Michal Uher
Authors‘ workplace:
Klinika radiologie a nukleární medicíny, FN a LF MU Brno
Published in:
Vnitř Lék 2021; 67(E-5): 13-16
Category:
Original Contributions
Overview
Aim: The analysis of the correlation between D-dimer and positive finding of pulmonary embolism on CT-angiography. Determination of the cut-off value of D-dimers, which would lead to a reduction in the number of examinations on CT-angiography.
Materials and methods: Patients who had positive D-dimer values in their blood tests and were examined using CT-angiography were included in the analysis. The relationship between the D-dimer value and the finding of pulmonary embolism on CT-angiography was analyzed. The analysis included 91 consecutive patients (46 women, 64,5 ± 18,8 years) examined from December 2019 to January 2020.
Results: The mean value of D-dimers in patients with proven pulmonary embolism on CT was statistically significantly higher than in patients without embolism (7,46 vs 2,93 mg/l; p < 0,001). Of the total number of patients examined on CT, pulmonary embolism was confirmed in 21 (23 %). We did not show a statistically significant difference in the incidence of pulmonary embolism in one sex (52 % female vs 48 % male; p = 1,000), nor the relationship between age and the incidence of pulmonary embolism (64,2 vs 64,5 years; p = 0,981). Based on ROC analysis, we determined a high probability of negative CT-angiography at the value of D-dimers up to 1,7 mg/l (negative predictive value 95,7 %). We also determined the value of D-dimers 3,5 mg/l, from which the probability of pulmonary embolism on CT is high (specificity 81,4 %).
Conclusion: Based on a retrospective analysis of patients with measured values of D-dimers and objectification of the finding of pulmonary embolism on CT-angiography, we demonstrated a very low probability of pulmonary embolism at D-dimer values up to 1,7 mg/l. We also showed that at values above 3,5 mg/l, the probability of pulmonary embolism is high.
Keywords:
D-dimer – Pulmonary embolism – CT-angiography
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Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
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