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Single perfusion defect and pulmonary embolism: angiographic correlation.
1Section of Nuclear Medicine, Hospital of Saint Raphael, New Haven, Connecticut 06511.
Summary
Single perfusion defects (SPD) on ventilation-perfusion scans indicate a moderate probability of pulmonary emboli (PE). Recent surgery was a significant factor in PE cases with SPD, often requiring pulmonary angiography for definitive diagnosis.
Area of Science:
- Radiology
- Nuclear Medicine
- Cardiovascular Imaging
Background:
- Pulmonary embolism (PE) is a significant cause of morbidity and mortality.
- Ventilation-perfusion (V-P) scans are commonly used to diagnose PE.
- Single perfusion defects (SPD) on V-P scans require careful interpretation.
Purpose of the Study:
- To determine the frequency of PE in patients with SPD.
- To evaluate the correlation between SPD and angiographic findings.
- To identify clinical factors associated with PE in SPD cases.
Main Methods:
- Retrospective review of 133 V-P scans with angiographic correlation.
- Analysis of 30 cases with SPD, assessing PE presence via angiography.
- Comparison of demographic data, clinical presentation, and imaging findings between PE and non-PE groups.
Main Results:
- Pulmonary embolism (PE) was confirmed by angiography in 15 of 30 cases with single perfusion defects (SPD).
- Recent surgery was present in 9 of 15 PE patients, but none of the non-PE patients.
- Scintigraphy often underestimated the size of the perfusion defect, with 7 PE cases showing defects larger than ventilation abnormalities.
Conclusions:
- Single perfusion defects (SPD) on V-P scans carry a moderate probability of pulmonary embolism (PE).
- Recent surgery is a notable clinical factor in patients with SPD and PE.
- Pulmonary angiography remains essential for confirming PE diagnosis when clinical suspicion is high.