Pulmonary embolism compression ultrasonography

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Editor(s)-In-Chief: The APEX Trial Investigators, C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

Compression Ultrasonography, also known as a Doppler study of the legs, or lower extremity noninvasive studies (LENIS) is used to evaluate a patient for the presence of deep venous thrombosis (DVT) in the lower extremities, which can lead to the development of a pulmonary embolism. The presence of a DVT shown by ultrasonography is enough to warrant anticoagulation without a V/Q or spiral CT scans. The decision to anticoagulant patient with a positive compression ultrasound is due to the strong association between deep vein thrombosis and subsequent pulmonary embolism. Compression ultrasonography is also a preferred method of evaluation during pregnancy, a time during which the other modalities would increase the risk of birth defects due to radiation exposure. A negative compression ultrasound does not rule out a pulmonary embolism, and an additional low-radiation dose scanning may be required in a pregnant patient to further rule out pulmonary embolism.