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[Pulmonary embolism: is scintigraphy useful after initial angio-CT?]
J F Paul1, J N Fiessinger, A Hernigou
1Service de radiologie vasculaire, Hôpital Broussais, 96, rue Didot, 75674 Paris Cedex 14. paul@hbroussais.fr
Journal De Radiologie
|August 1, 2000
Summary
Ventilation-perfusion scintigraphy is not recommended after a negative helical CT scan for pulmonary embolism (PE). Pulmonary angiography is necessary when doubt persists after a normal CT scan to rule out PE.
Area of Science:
- Diagnostic imaging in pulmonary medicine
- Cardiopulmonary diagnostics
Background:
- Pulmonary embolism (PE) is a critical diagnosis.
- Helical CT angiography is a primary imaging modality for PE detection.
Purpose of the Study:
- To evaluate the utility of ventilation-perfusion (V/P) scintigraphy following a negative helical CT scan in patients with suspected pulmonary embolism.
Main Methods:
- Twenty-eight patients with suspected PE underwent helical CT.
- Negative CT scans were followed by V/P scintigraphy.
- Pulmonary angiography served as the gold standard for discrepant cases.
Main Results:
- Twenty-one patients had PE confirmed by CT.
- Of the 7 patients with negative CT scans, 2 had low-probability V/P scans and PE was excluded.
- Five patients had V/P scan results that were intermediate or high probability, but none had PE confirmed by angiography.
Conclusions:
- Ventilation-perfusion scintigraphy is not appropriate after a negative helical CT scan for diagnosing PE.
- Pulmonary angiography is indicated for persistent diagnostic uncertainty after a normal helical CT scan.