Evaluation the Diagnostic Role of Trans-thoracic Ultrasound in Detection of Patients with Pulmonary Embolism

Background: As a result, pulmonary embolism is frequently underdiagnosed and undertreated; therefore, its actual incidence is likely higher than reported. As a result, the majority of patients with pulmonary embolism go undiagnosed, highlighting the pressing need for a simple, alternative, and widely used diagnostic method.Aim: With the goal of determining if trans-thoracic ultrasonography is a reliable and effective method for identifying patients with a clinical suspicion of pulmonary embolism.Subjects and methods: This is a prospective cross-sectional diagnostic accuracy study carried out during the period from April 2023 to July 2025, on fifty consecutively enrolled patients with clinically suspected pulmonary embolism, who were admitted to the Chest Department in Al-Hussein and Bab-Elshaeria University Hospitals, Cairo, Egypt.Results: Transthoracic ultrasound demonstrated that pulmonary embolism was most frequently right-sided (52.6%) and mainly affected the lower lung zones (84.2%), with absent vascularization on color Doppler in 82.35% of cases. Lesions included consolidation (12%), infarction (56%), and pleural effusion (8%), while 24% showed no abnormal findings. Transthoracic ultrasound results were consistent with computed tomography pulmonary angiography, with a sensitivity of 80%, specificity of 60%, PPV of 82.3%, NPV of 56.2%, and overall accuracy of 74%.Conclusion: Transthoracic ultrasound is a simple, non-invasive, and accessible tool with reasonable diagnostic accuracy for detecting peripheral pulmonary embolism. However, its sensitivity for central lesions is limited, and computed tomography pulmonary angiography remains the gold standard for definitive diagnosis.