Value Analysis Of Revised Geneva Scores Combined With Ultrasonography To The Diagnosis Of Pulmonary Embolism

Objective: To analysis the value of Revised Geneva scores combined withtransthoracic echocardiography and lower extremity compressive ultrasonography fordiagnosis of pulmonary embolism (PE).Methods:286cases with suspected PE diagnosed in our hospital respiratorymedicine were collected and analyzed from October,2010to December,2012. Eachof the patients with suspected pulmonary embolism was Revised Geneva score,transthoracic echocardiography and lower extremity compressive ultrasonographyexamination. CTPA as the “gold standard” of PE．Patients with suspected pulmonaryembolism were divided into pulmonary embolism group and the non-pulmonaryembolism group after CTPA examination. The diagnosis value was evaluated by eachtest index alone or in combination with evaluation indexes which are frequently usedin diagnostic test.Results:1.The specificity of Revised Geneva score highly possible was98.9%,positive likelihoed ratio more than10was16.00, Positive predictive value was97.1%.2.The sensitivity of Revised Geneva score respectively associated withtransthoracic echocardiography, lower extremity compressive ultrasonography werehigher than Revised Geneva score single check, The differences has a statisticalsignificance (P﹤0.05）. The sensitivity of transthoracic echocardiography combinedwith lower extremity compressive ultrasonography were higher than that of eachsingle item check, The differences has a statistical significances (P﹤0.05）. Thesensitivity of Revised Geneva score combined with transthoracic echocardiographyand lower extremity compressive ultrasonography were higher than any two joint,The differences also has a statistical significance (P﹤0.05）.3.When the result of Revised Geneva combineed with transthoracicechocardiography combined and lower extremity compressive ultrasonography wereall negative,negative likelihood ratio was less than0.1. Conclusions:1.The higher specificity of Revised Geneva score highly possiblecan reduce the misdiagnosis rate of pulmonary embolism, and had diagnostic value.2.Revised Geneva score combined with ultrasound can reduced the Under-diagnosis of PE.3.Revised Geneva score, transthoracic echocardiography and lower extremitycompressive ultrasonography examination are all negative, which has important valueto exclude pulmonary embolism.