Pol J Radiol. 2015 May 13;80:252-8. doi: 10.12659/PJR.893793. eCollection 2015.

Comparison of multidetector computed tomography findings with clinical and laboratory data in pulmonary thromboembolism.

Polish journal of radiology

Zuhal Gülşen, Pınar Nercis Koşar, Fatma Dilek Gökharman

PMID: 26029288 PMCID: PMC4434981 DOI: 10.12659/PJR.893793

Abstract

BACKGROUND: Pulmonary thromboembolism (PTE) is a common disease with a high mortality rate that is difficult to diagnose and treat. Because of the variety of clinical symptoms and signs, it is difficult to diagnose. Therefore, the diagnosis of PTE is mainly confirmed by imaging techniques. The aim of this study was to evaluate whether there is any corelation of the Wells rule, D-dimer and LDH values with computerized tomography pulmonary angiography (CTPA) findings in PTE diagnosis.

MATERIAL/METHODS: A consecutive series of 62 patients, which included 31 males and 31 females, with high/moderate/low risk of embolism according to Wells pulmonary embolism score, selected from the emergency service and/or outpatient clinic, enrolled in this prospective study. The patients with clinical or laboratory findings of elevated D-dimer level or elevated lactate dehydrogenase (LDH) level were suspected of embolism and underwent tomography.

RESULTS: PTE was detected in 26 patients (42%). A significant difference was not detected between tomography finding positive and negative embolisms in the patient group in terms of age or gender distribution (P=0.221 and P=0.416, respectively). No significant difference was detected between tomography finding positive and negative embolisms in the patient group in terms of elevated LDH or/and D-dimer levels (P=0.263 and P=1.000, respectively). The distribution of low-risk-factor patients in the non-embolism group, and the distribution of high-risk-factor patients in the embolism-positive group was statistically significantly high (P<0.001). There was no statistically significant difference between the groups (P=0.053). Correlation test showed no correlation between LDH and D-dimer levels. (r=0.214, P=0.180).

CONCLUSIONS: In conclusion, when a patient presents with chest pain, our carrying out LDH and D-Dimer tests will not exclude PTE without CTPA. However, we suggest that LDH isoenzymes should be studied in further research.

Keywords: Fibrin Fibrinogen Degradation Products; Lactate Dehydrogenases; Multidetector Computed Tomography; Pulmonary Embolism

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