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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
Published on: February 10, 2023
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Diagnosing venous thromboembolism in pregnancy
Thomas Grüning1, Rebecca E Mingo1, Matthew G Gosling2
11 Department of Nuclear Medicine, Derriford Hospital, Plymouth, UK.
The British Journal of Radiology
|April 9, 2016
Summary
Ventilation/perfusion SPECT and CT pulmonary angiography offer similar diagnostic accuracy for pulmonary embolism in pregnant patients. However, VQ SPECT provides a lower radiation dose to the mother, making it a preferable imaging choice.
Area of Science:
- Radiology
- Obstetrics
- Cardiology
Background:
- Thromboembolism is a significant concern during pregnancy.
- Accurate diagnosis of pulmonary embolism (PE) in pregnant patients is crucial.
- Previous studies have not fully evaluated the diagnostic performance of ventilation/perfusion single-photon emission CT (VQ SPECT) in pregnancy.
Purpose of the Study:
- To compare the imaging outcomes and radiation doses of VQ SPECT, CT pulmonary angiography (CTPA), and Doppler ultrasound for suspected thromboembolism in pregnant patients.
- To assess the diagnostic yield and safety of these imaging modalities during pregnancy.
Main Methods:
- Retrospective analysis of 168 pregnant patients undergoing VQ SPECT, CTPA, or Doppler ultrasound for suspected thromboembolism.
- Inclusion of a control group of 89 non-pregnant patients matched for age and sex who underwent VQ SPECT.
- Recording of imaging outcomes and calculation of individual patient radiation doses.
Main Results:
- VQ SPECT and CTPA demonstrated similar diagnostic yields for PE, identifying it in approximately 1 in 7 patients.
- CTPA scans had a suboptimal quality in one-third of cases.
- Doppler ultrasound identified deep venous thrombosis in about 1 in 15 patients.
- The prevalence of PE in pregnant patients was comparable to the non-pregnant control group.
- VQ SPECT resulted in lower effective and maternal breast radiation doses compared to CTPA, with comparable fetal doses.
Conclusions:
- VQ SPECT and CTPA offer comparable diagnostic performance for PE in pregnancy.
- VQ SPECT is associated with a lower maternal radiation dose (effective and breast dose) than CTPA.
- This study is the first to report on the diagnostic performance of VQ SPECT in pregnancy in a routine clinical setting.
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