Value of D‑dimer levels for the diagnosis of pulmonary embolism: An analysis of 32 cases with computed tomography pulmonary angiography

Gao,Hui; Liu,Hu; Li,Yanjing

doi:10.3892/etm.2018.6314

Value of D‑dimer levels for the diagnosis of pulmonary embolism: An analysis of 32 cases with computed tomography pulmonary angiography

Authors:
- Hui Gao
- Hu Liu
- Yanjing Li
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Affiliations: Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China, Cardiovascular Medicine Center, The Affiliated Hospital of Yan'an University, Yan'an, Shaanxi 716000, P.R. China, Department of Radiology, The Affiliated Hospital of Yan'an University, Yan'an, Shaanxi 716000, P.R. China
Published online on: June 15, 2018 https://doi.org/10.3892/etm.2018.6314
Pages: 1554-1560

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Abstract

D‑dimer levels correlate with the extent of pulmonary embolism (PE) on computed tomography pulmonary angiography (CTPA), but the use of D‑dimer alone for screening and diagnosing PE remains controversial. This study compared the utility of plasma D‑dimer levels for diagnosing PE with that of CTPA (gold standard). This was a retrospective analysis of 32 consecutive patients with suspected PE at the Affiliated Hospital of Yan'an University between OctoberC 2010 and March 2011. Blood was sampled before thrombolytic therapy was administered. D‑dimer levels were measured using an automatic system. CTPA was used to diagnose PE and was performed within 48 h of blood sampling using a Siemens Somatom Sensation 64 computed tomography (CT) scanner. ROC curve analysis was performed to evaluate the diagnostic utility of D‑dimer levels, with CTPA as the gold standard. Among the 32 patients, CTPA identified 26 patients with PE and 6 patients without obvious abnormality. Using a threshold value of 1.3 µg/ml for D‑dimer level, the diagnosis of PE was achieved with a sensitivity of 96.2%, specificity of 50.0%, positive predictive value of 89.3%, negative predictive value of 75.0% and accuracy of 87.5%. D‑dimer levels were significantly higher in patients positive for PE on CTPA than in those negative for PE on CTPA (9.85±7.14 vs. 2.82±2.65 µg/ml, P=0.001). Based on ROC curve analysis, the optimal threshold value for D‑dimer level in the diagnosis of PE was 1.9 µg/ml. To conclude, D‑dimer could be a simple, fast and inexpensive screening method for excluding a diagnosis of PE.

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