Results that “rule-in” or “rule-out” PE
| Results . |
|---|
| Diagnostic for PE |
| CTPA |
| Intraluminal filling defect in a lobar or main pulmonary artery |
| Intraluminal filling defect in a segmental pulmonary artery AND moderate or high CPTP |
| V/Q scan |
| High-probability scan AND moderate or high CPTP |
| Positive diagnostic test for DVT (with a nondiagnostic V/Q scan or CTPA, or scan not done) |
| Rules-out PE |
| CTPA |
| Negative good quality scan |
| Perfusion scan (usually part of V/Q scan) |
| Normal |
| D-dimer |
| Negative very sensitive test (eg, D-dimer <500 μg/L) AND low or moderate CPTP |
| Negative moderately sensitive test AND low CPTP |
| In patients over 50 y, D-dimer level <10 times the patient's age AND a low or moderate CPTP |
| Nondiagnostic V/Q scan or CTPA AND normal proximal venous US AND one of: |
| Low CPTP |
| Negative moderately or very sensitive D-dimer test |
| Normal repeat proximal US after 7 d and 14 d |
| Results . |
|---|
| Diagnostic for PE |
| CTPA |
| Intraluminal filling defect in a lobar or main pulmonary artery |
| Intraluminal filling defect in a segmental pulmonary artery AND moderate or high CPTP |
| V/Q scan |
| High-probability scan AND moderate or high CPTP |
| Positive diagnostic test for DVT (with a nondiagnostic V/Q scan or CTPA, or scan not done) |
| Rules-out PE |
| CTPA |
| Negative good quality scan |
| Perfusion scan (usually part of V/Q scan) |
| Normal |
| D-dimer |
| Negative very sensitive test (eg, D-dimer <500 μg/L) AND low or moderate CPTP |
| Negative moderately sensitive test AND low CPTP |
| In patients over 50 y, D-dimer level <10 times the patient's age AND a low or moderate CPTP |
| Nondiagnostic V/Q scan or CTPA AND normal proximal venous US AND one of: |
| Low CPTP |
| Negative moderately or very sensitive D-dimer test |
| Normal repeat proximal US after 7 d and 14 d |