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[Comparison of ventilation-/perfusion scintigraphy with spiral CT in acute lung embolism]
S M Neumann1, J Freyschmidt, B R Holland
1Radiologisches Zentrum, Zentralkrankenhaus St.-Jürgen-Strasse, Bremen.
Aim:
Evaluation of the validity of spiral-CT compared with ventilation/perfusion (v/p) scintigraphy, the standard diagnostic tool in patients with suspected pulmonary embolism.
Patients And Methods:
Prospective study of 70 patients with symptoms of acute pulmonary embolism: examination with both methods within 4 hours.
Results:
In 46 patients pulmonary embolism could be unequivocally excluded by both methods. Patients with high-probability-Tc-scans predominantly had central emboli on CT. In cases with medium or low probability-Tc-scans thrombi were usually visible in segmental arteries. In one patient with a non-suspicious scintigram spiral-CT was able to detect emboli in multiple segmental arteries.
Conclusion:
Spiral-CT is a fast, safe and almost always available method for detection of pulmonary embolism. In our hands it is superior to v/p-scintigraphy. It allows direct detection of a thrombus and has additional advantages in differential diagnosis (e. g. lung carcinoma, infectious infiltration). In patients with clinical suspicion of pulmonary embolism spiral-CT should be the primary diagnostic modality.