Diagnostics Of Pulmonary Embolism Research Articles

Artificial Intelligence Evidence-Based Current Status and Potential for Lower Limb Vascular Management.

Consultation prioritization is fundamental in optimal healthcare management and its performance can be helped by artificial intelligence (AI)-dedicated software and by digital medicine in general. The need for remote consultation has been demonstrated not only in the pandemic-induced lock-down but also in rurality conditions for which access to health centers is constantly limited. The term “AI” indicates the use of a computer to simulate human intellectual behavior with minimal human intervention. AI is based on a “machine learning” process or on an artificial neural network. AI provides accurate diagnostic algorithms and personalized treatments in many fields, including oncology, ophthalmology, traumatology, and dermatology. AI can help vascular specialists in diagnostics of peripheral artery disease, cerebrovascular disease, and deep vein thrombosis by analyzing contrast-enhanced magnetic resonance imaging or ultrasound data and in diagnostics of pulmonary embolism on multi-slice computed angiograms. Automatic methods based on AI may be applied to detect the presence and determine the clinical class of chronic venous disease. Nevertheless, data on using AI in this field are still scarce. In this narrative review, the authors discuss available data on AI implementation in arterial and venous disease diagnostics and care.

Современные проблемы патогенеза и диагностики тромбоэмболии легочной артерии

Современные проблемы патогенеза и диагностики тромбоэмболии легочной артерии

4D strain in pulmonary embolism diagnostics: a case report

4D strain in pulmonary embolism diagnostics: a case report

P2276Assessment of mitral and tricuspid annular velocity ratios improves pulmonary embolism diagnostics in acute decompensated heart failure

P2276Assessment of mitral and tricuspid annular velocity ratios improves pulmonary embolism diagnostics in acute decompensated heart failure

Pulmonary embolism during delivery – treatment and outcome

Pulmonary embolism during delivery is not a frequent occurrence. It is often impossible to ascertain whether it is a case of embolism by amniotic fluid or thromboembolism. Diagnostics of pulmonary embolism in labor is based solely on clinical symptoms. Immediate interdisciplinary treatment with cardiopulmonary resuscitation, hemodynamic stabilization, and correction of haemostasis disorders play a decisive role in prognosis. This paper presents diagnostics, treatment, and consequences of pulmonary embolism in expulsion phase during delivery in epidural anesthesia of a multiparous patient aged 37.

Pulmonary embolism diagnostics from the driver function

Ventricular driver functions are not readily measured in the ICU, but can clearly indicate the development of pulmonary embolism (PE) otherwise difficult to diagnose. Recent work has developed accurate methods of measuring these driver functions from readily available ICU measurements. This research tests those methods by assessing the ability of these driver functions to diagnose the evolution of PE.

Improving diagnostics of pulmonary embolism with clinical prediction models in a clinic of pulmonary diseases

Purpose of the Study: Clinical prediction models have been developed to assess the pre-test probability for pulmonary embolism (PE). The Wells model and the revised Geneva score are the two most well studied. Our purpose was to compare the two prediction models, and indentify the frequent clinical findings of PE in patients admitted to the University Clinic of Pulmonary and Allergic Diseases Golnik. Methods: In 100 random emergency department patients and hospital inpatients with suspected PE and performed pulmonary CT angiography (CTPA) as the gold standard, a retrospective assessment of the clinical probability of PE by the Wells rule and the revised Geneva score was made. ECG, D-dimer, NT-proBNP, arterial blood gas analysis, chest X-ray, CTPA and 13 other clinical findings were analysed as well. Results: Average age was 65 years (SD 14.5), 39 % were male. The overall prevalence of PE was 33 %. The rates of PE in low, moderate, and high PE risk groups as determined according to the Wells model and the revised Geneva score were 3.7, 53,1, 100, and 14.3, 32.1, 83.3 %, respectively. ROC analysis showed that the Wells model was statistically more accurate than the Geneva score with the area under the curve (AUC) in Wells model 0.85 (95 % CI 0.762–0.936) and in Geneva score 0.73 (95 % CI 0.612–0.838). Sudden dyspnea, active malignancy, venous thromboembolism (VTE) history, estrogen therapy, deep vein thrombosis (DVT) signs, ECG changes and lower PaCO2 were significantly more frequent in PE group. All patients with PE had an increased concentration of D-dimer, and no PE were diagnosed in the group of patients with normal D-dimer. CTPA was ordered in 17 % of patients with low pre-test probability of PE according to Wells criteria and normal D-dimer. Conclusions: The Wells model is more accurate than the Geneva scoring system for the diagnosis of PE in patients admitted to a pulmonary clinic. Additional findings, such as sudden dyspnea, estrogen therapy, ECG changes and lower PaCO2, should always be incorporated in clinical assessment of PE. Adding the Wells algorithm to the clinical pathway for PE management might slightly decrease the number of CTPA.

Diagnostics of pulmonary embolism with emphasis on ventilation/perfusion scintigraphy and dead-space analysis

Ventilation/perfusion scintigraphy, a first hand method for diagnosis of pulmonary embolism, PE, is challenged by tomography of the pulmonary arteries, CT. An additional method is based upon dead space analysis. Tomographic ventilation/perfusion scintigraphy, V/PSPECT is superior to planar technique. Important is interpretation criteria based upon pattern recognition and clinical information. With optimal strategy, the rate of non-diagnostic findings is only about 1%. The sensitivity of CT is too low to exclude subsegmental PE,. The radiation dose is for CT is several times higher than for V/PSPECT. Quantification of PE, only offered by V/PSPECT has impact on therapy and is vital for follow up. Limited availability of V/PSPECT makes CT an essential element in a strategy for diagnosis of PE. The single breath test for CO2 offers an alternative when imaging techniques are not available or when radiation is a particular problem in early pregnancy.