[Pulmonary embolism. Perfusion and ventilation pulmonary scintigraphy findings (author's transl)[]

After discussing the rather particular misadventures that the concept, diagnosis, and treatment of pulmonary embolism have been subjected to in France, the techniques for performing and analyzing results of pulmonary scintigraphy are described. Typical findings are one (or more) totally excluded areas in the biopsy specimen, easily systematized on a profile film. Though scintigraphy imaging appears to be essential, the sensitivity of the technique enabling positive exclusion of a pulmonary embolus if the image is normal, it is not specific. Results of the investigation appear to vary according to the use of a "soft approach" (repeated scintigraphy, heparinization) or a "hard approach" (pulmonary angiography, venography, fibrinolytic). Practical experience tends to show, however, that fallacies appear mainly when an attempt is made to elucidate cases other than acute emergencies, as for example in patients with lung cancer, women on the contraceptive pill, and chronic bronchopathy patients. It is strongly recommended that clinical studies be conducted to compare the "soft" and "hard" approaches, in order to obtain a consensus of opinion on the diagnosis and treatment of pulmonary embolism, a subject which remains passionate. . . and passional.