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The use of lower extremity venous ultrasound has been suggested as the next noninva-sive test in patients without a definitive diagnosis based on clinical assessment and lung scanning.- The rate of positive findings on lower extremity venous ultrasound examinations in patients with PE is reportedly 50%.> That would suggest a 20% positive rate for venous ultrasound under these circumstances, leaving 80% of patients with low-probability lung scans and high clinical suspicion without definitive diagnoses. Our data indicate that there is a 95% CI of 2.7 to 18% for PE in this group of patients, a frequency high enough to require further testing for definitive diagnosis.

Our series was retrospective and, therefore, is limited by potential selection bias. We have no clinical outcome data regarding patients with high clinical suspicion and low-probability lung scans, but without ultrasound examinations. canadian pharmacy

In this series, the majority of the PEs (80%) were small subsegmental PEs, with poor correlations between lung scans and angiograms. Currently, spiral CT is not accurate for the diagnosis of subsegmental PEs." Therefore, for this subset of patients, the only definitive diagnostic test at this time is pulmonary angiography.
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