Zhu Ran, Ma Xiao-Chun
Department of Critical Care Medicine, the First Affiliated Hospital of China Medical University, Shenyang110001, Liaoning Province, China.
Critical Care Ultrasound Study Group, Beijing, China.
J Transl Int Med. 2017 Dec 29;5(4):200-204. doi: 10.1515/jtim-2017-0034. eCollection 2017 Dec.
Pulmonary embolism (PE) is a clinical emergency that will increase the mortality if complicated with unstable hemodynamics. Because of its nonspecific clinical symptoms, it's a great challenge to make a PE diagnosis. The golden standard to diagnose PE is computed tomography of pulmonary artery (CTPA), but a diagnosis of PE also composed of evaluation of PE risk factors, possibilities, and risk stratification. Ultrasonography may detect right ventricle strain related to hemodynamic change, intravascular thrombosis, thrombosis in right heart or pulmonary arteries, pulmonary infarction, and local pleural effusion. Combination of ultrasound and traditional PE possibility evaluation score may further improve the pretest probability of CTPA. A comprehensive ultrasonography may sometimes rule out PE and may disclose other causes for the clinical situations. A heart-lung-vessel-integrated multiorgan ultrasonography can help with the diagnosis of PE and so should be a necessary weapon for the physicians.
肺栓塞（PE）是一种临床急症，若合并血流动力学不稳定会增加死亡率。由于其临床症状不具特异性，PE的诊断极具挑战性。诊断PE的金标准是肺动脉计算机断层扫描（CTPA），但PE的诊断还包括对PE危险因素、可能性及风险分层的评估。超声检查可能检测到与血流动力学变化相关的右心室应变、血管内血栓形成、右心或肺动脉血栓、肺梗死及局部胸腔积液。超声与传统PE可能性评估评分相结合可进一步提高CTPA的检查前概率。全面的超声检查有时可排除PE，并可揭示临床情况的其他病因。心肺血管一体化多器官超声检查有助于PE的诊断，因此应成为医生必备的手段。
