Introduction: Pulmonary thromboembolism (PTE) is a clinical condition of high mortality and morbidity rate. The studies to establish proper diagnostic approaches for PTE using noninvasive diagnostic tools have been going on. The aim of this study was to determine the relationship between D-dimer test, lower extremity venous Doppler ultrasonography (US) and lung perfusion scan and the clinical possibilities in patients who had symptoms, physical examination and nonspesific laboratory consistent with PTE and/or deep venous thrombosis (DVT).

Material and Methods: Fifty-three patients with clinically PTE were enrolled into the study. Whole blood test, routine biochemical tests, chest X- ray, electrocardiography, D-dimer test (latex), lower extremity venous Doppler US and lung perfusion scan were performed respectively.

Results: Twenty-seven of 53 patients were females (51%) while 26 were males (49%). The mean age was 67 ±15 yrs (range: 22-93 yrs). Of the patients 45.2 % had PTE with high probability, 37.7 % with intermediate probability and 16.9 % with low probability. Positive D-dimer tests were respectively 91.6 %, 50 % and 44.4 %. In addition, 49 % had PTE with high probality, 16.9 % with intermediate probability and 39.9 % with low probality in according to lung perfusion scan results. Positive D-dimer tests were respectively 92.3 %, 66.6 % and 33.3 %. The sensitivity and specificity of D-dimer test were 92% and 66%.

Conclusion: Our results showed that, if the clinical probability of PTE is low and D-dimer test is negative, PTE might be excluded. In cases with clinically and sintigraphically high- intermediate probable PTE, although D-dimer test is negative, it should be proceeded further investigations such as, angiography, venography or tomography.

Pulmonary thromboembolism Deep venous thrombosis D-dimer test