Clinical Use Of Ultrasound In The Early Diagnosis Of Pulmonary Embolism

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Abstract
The advantages of this new technic, which needs further evaluation and verification, would appear to be it is simple; the tracings can be done rapidly, in approximately 10-15 min., which may expand the applicability of pulmonary embolectomy; it requires no manipulation or moving of the patient; positive diagnoses are made in the presence of completely negative chest X-rays; small emboli, at least in terms of projection of underlying areas of ischemia on the chest wall, can be diagnosed; positive tracings can be obtained within 10 to 20 min. of the time of embolization; by the nature of the technic, the most prominent confusing diagnoses myocardial infarction, dissecting aneurysm, acute pericarditis with tamponade, bacteremic shock, etc. should not be logically expected to show an ultrasound pattern similar to that of embolus; it is not necessary to have necrosis of lung tissue; to obtain an embolus pattern; the technic is perfectly safe; it can be used as a safe, simple method of following the progression of a known embolus to its eventual resolution. The major disadvantages of the technic appear to be that the underlying principle of the technic allow for false positives in the presence of marked increases in sub-pleural density from other pulmonary disease processes, and as with any other new technic, some experience in the technical performance of the scan is necessary to eliminate artifacts in interpretation. Considering the magnitude of the problem, it is likely that continued and judicious use of this new diagnostic approach will give us greater insight into its limitations and, hopefully, into possibilities for extension of its usefulness.
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