All the following test results can exclude pulmonary embolism, EXCEPT:
Correct Answer: D-Dimer Test: Positive
Description: Test results that confirm or exclude pulmonary embolism (adapted from Kearon) Diagnostic for pulmonary embolism (>=85% probability of pulmonary embolism) Computed tomography (CT) pulmonary angiogram: Intraluminal filling defect in a lobar or main pulmonary aery Intraluminal filling defect in a segmental pulmonary aery and moderate or high CPTP (clinical pre-test probability.) Ventilation-perfusion scan: High probability scan and moderate or high CPTP Positive diagnostic test for deep vein thrombosis (with a non-diagnostic ventilation-perfusion scan or CT pulmonary angiogram) Excludes pulmonary embolism (<=2% probability of progressive venous thromboembolism during 3 months' follow-up+) CT pulmonary angiogram: Normal Perfusion scan: Normal D-dimer test: Negative test which has high sensitivity (>95%) and low or moderate CPTP Negative test which has moderately high sensitivity (>85%) and low CPTP Non-diagnostic ventilation-perfusion scan or suboptimal CT pulmonary angiogram and normal venous ultrasound of the proximal veins and Low CPTP or Negative D-dimer test which has moderately high sensitivity (>=85%) or Normal repeat venous ultrasound scans of the proximal veins after 7 and 14 days Ref: Kearon C. Diagnosis of pulmonary embolism. CMAJ2003;168:183-94; Diagnosis and management of pulmonary embolism ; BMJ 2013;346:f75.
Category:
Radiology
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