Marco J.L. van Strijen, MD; Wouter de Monyé, MD; Jan Schiereck, MD; Gerard J. Kieft, MD; Martin H. Prins, MD; Menno V. Huisman, MD; Peter M.T. Pattynama, MD; Advances in New Technologies Evaluating the Localisation of Pulmonary Embolism (ANTELOPE) Study Group*
Acknowledgments: The results of this study are part of the results of the ANTELOPE Study Group (Advances in New Technologies Evaluating the Localisation of Pulmonary Embolism), a Dutch prospective multicenter trial on pulmonary embolism. The authors thank Annette van den Berg-Huijsmans, Gerda Labadie, and Ria Koolma for their help with the statistical analysis of the results and management of the data.
Grant Support: By grant D94-090 from the Dutch National Health Insurance Council (Ziekenfondsraad).
Requests for Single Reprints: Menno V. Huisman, MD, Department of General Internal Medicine, Room B3Q-84, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands; e-mail, email@example.com.
Current Author Addresses: Drs. van Strijen and Kieft: Department of Radiology, Leyenburg Ziekenhuis, Leyweg 275, 2545 CH The Hague, the Netherlands.
Dr. Monye': Department of Radiology, Leiden University Medical Cen-ter, PO Box 9600, 2300 RC Leiden, the Netherlands.
Dr. Schiereck: Department of Radiology, Utrecht Medical Center, Utre-cht, PO Box 85500, 3508 GA Utrecht, the Netherlands.
Dr. Prins: Department of Epidemiology, Academic Hospital Maastricht, PO Box 616, 6200 MD Maastricht, the Netherlands.
Dr. Huisman: Department of General Internal Medicine, Room B3Q-84, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands.
Dr. Pattynama: Department of Radiology, Erasmus Medical Center Rot-terdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands.
Author Contributions: Conception and design: M.J.L. van Strijen, G.J. Kieft, M.H. Prins, M.V. Huisman, P.M.T. Pattynama.
Analysis and interpretation of the data: M.J.L. van Strijen, M.H. Prins, M.V. Huisman.
Drafting of the article: M.J.L. van Strijen, M.V. Huisman, P.M.T. Pat-tynama. Critical revision of the article for important intellectual content: M.J.L. van Strijen, W. de Monye', G.J. Kieft, M.H. Prins, M.V. Huisman, P.M.T. Pattynama.
Final approval of the article: M.J.L. van Strijen, W. de Monye', J. Schiereck, G.J. Kieft, M.H. Prins, M.V. Huisman, P.M.T. Pattynama.
Provision of study materials or patients: M.J.L. van Strijen, W. de Monye', J. Schiereck, M.H. Prins, M.V. Huisman.
Statistical expertise: M.H. Prins.
Obtaining of funding: G.J. Kieft, M.H. Prins, P.M.T. Pattynama.
Administrative, technical, or logistic support: P.M.T. Pattynama. Collection and assembly of data: M.J.L. van Strijen, W. de Monye', J. Schiereck.
van Strijen MJ, de Monyé W, Schiereck J, Kieft GJ, Prins MH, Huisman MV, et al. Single-Detector Helical Computed Tomography as the Primary Diagnostic Test in Suspected Pulmonary Embolism: A Multicenter Clinical Management Study of 510 Patients. Ann Intern Med. 2003;138:307-314. doi: 10.7326/0003-4819-138-4-200302180-00009
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Published: Ann Intern Med. 2003;138(4):307-314.
The clinical diagnosis of pulmonary embolism is difficult because the symptoms are nonspecific. Therefore, objective diagnostic imaging is needed in all patients. Helical computed tomography (CT) of the pulmonary arteries is rapidly gaining acceptance as a diagnostic test for suspected pulmonary embolism. Helical CT is a relatively noninvasive procedure that can be used to diagnose pulmonary embolism by directly imaging the intravascular clot. Since the initial report on helical CT in suspected pulmonary embolism almost a decade ago (1), numerous validation studies have evaluated the accuracy of helical CT; overall sensitivities range from 64% to 100% and specificities range from 89% to 100% (2-4). It has become evident that helical CT cannot identify all patients with pulmonary embolism because it may miss clots confined to the subsegmental pulmonary artery branches. An advantage of helical CT is that it can provide an alternative diagnosis to explain the patient's signs and symptoms. This is relevant because pulmonary embolism is not confirmed in two thirds of the patients in whom it was clinically suspected. From theoretical cost-effectiveness analyses, an optimal diagnostic strategy would combine helical CT with compression ultrasonography to detect venous thromboembolism (5). However, these analyses have not been validated by prospective clinical management studies in consecutive patients with suspected pulmonary embolism (5, 6).
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Emergency Medicine, Pulmonary/Critical Care, Venous Thromboembolism, Pulmonary Embolism.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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